New Beginnings: Pregnancy Guides - Mission Health

New Beginnings

W ELCOME TO M ISSION H OSPITAL! 

We are delighted that you have chosen Mission Hospital for your upcoming birth. We will strive to exceed your expectations 

in keeping with our MERIT values of mercy, excellence, respect, integrity and trust/teamwork. 

We hope that our New Beginnings booklet will help you: 

• Become familiar with Mission Hospital’s services for families 

• Learn more about pregnancy, birth and the early days of parenting 

• Make positive healthy choices for yourself and your baby 

• Become better informed about the many choices during this special time 

On behalf of the staff and administration here at Mission, our sincerest wishes for a healthy, joyous birth and a positive 

transition into your early days of parenting. 

Sincerely, 

Ginny Raviotta 

Director of Women’s Services 

Welcome to 

Mission

U SING THIS INFORMATION 

Your doctor or midwife and their staff will be your main advisors during your pregnancy. This booklet will give you information 

about pregnancy to help you prepare for a birth at Mission and help you plan for your new baby. 

In this booklet you will find: 

• An OB Pre-Admission Form to register you at Mission. Or register online at missionhospitals.org/obpreadmission. 

• Information about classes and other resources. 

• Information about what to expect when you come to Mission Hospital. 

• Four “New Beginnings: Pregnancy Guides” will give you information about pregnancy, birth, and caring 

for a new baby. Look for “To Do Lists” for organizing and planning. 

The New Beginnings: Pregnancy Guides are color coded. Each color helps you know when to read the information. 

Pink is for early in the pregnancy (1-14 weeks). This guide has prenatal parenting class information, community resources and 

phone numbers, and support services for women. 

Blue is for the middle of the pregnancy (15-28 weeks). 

Green is for late pregnancy (29-40 weeks). 

Orange is a guide for postpartum and baby care. 

In addition to New Beginnings, subscribe to our weekly e-newsletter, which includes information on: 

• Mission services 

• Pregnancy 

• Health and wellness 

• Newborn/child development, up to age 3 

• Breastfeeding 

Feel free to share this email with family and friends across the country. 

Visit theparentreview.com/missionhealth to sign up. 

If you would like to share the New Beginnings 

booklet with family and friends, have them 

visit missionhospitals.org/maternity.

In the 

Beginning

First 

Trimester 

PREGNANCY GUIDE 

Months 1, 2 and 3 

New Beginnings 

In the Beginning 

M OM 

Conception to 4 

weeks 

Finding out you are pregnant can be 

exciting and maybe a little scary. Your 

first clue may be a missed period. In the 

first weeks your body begins to change 

because of female hormones. A basic 

pregnancy test checks for the hormone 

called hCG (human chorionic 

gonadotropin). This hormone is found 

in your blood and in your urine. 

4 to 8 weeks 

You may begin to feel the changes in 

your body as early as 6-8 weeks after 

you have become pregnant. The most 

common changes are: 

• Feeling tired most of the time 

• Tender breast and nipples 

• Urinating a lot 

• Nausea and maybe vomiting 

• Bleeding gums and nose bleeds 

• Dizzy or fainting spells 

• Headaches 

• Big changes in your moods like being 

upset, crying a lot or feeling scared 

These changes can last a few weeks up 

to 20 weeks. To help you deal with these 

changes, try these tips. 

• Plan to rest during the day or after 

you get home. Rest is very important 

for you and your growing baby. 

• Go to bed earlier. 

• Get help with chores or do fewer 

chores for a while. 

• Wear a bra that fits and supports you. 

You may want to wear it to bed. 

• Empty your bladder regularly. 

• Eat small meals every 2 hours. Keep 

crackers next to your bed to eat 

before you get up. 

• Don’t drink liquids when you first get 

up or with your meals or snacks. 

• Try taking B6 vitamin, 25mg at 

breakfast, lunch, dinner, and at 

bedtime. This takes about 4 days to 

begin helping. 

• Wear loose clothes; nothing tight 

around your belly. 

• Use a cold mist vaporizer close to 

your bed. 

• Drink peppermint or ginger tea. 

• Ginger capsules 500 mg 4 times a day. 

• Avoid greasy or spicy foods. 

• Move slowly when you get out of the 

bed or stand up. 

• Use a soft bristle child’s toothbrush. 

Avoid brushing gums too hard. Floss 

your teeth once a day. 

• Talk with your family, friends, or care 

provider about how you feel. 

• Ask questions and read books to 

help you understand and cope with 

these changes. 

8 to 12 weeks 

During this month your body may 

begin to change shape. Your breasts 

may get bigger, clothes may feel tight 

around your waist and low abdomen. 

You may have gained 3-4 pounds by the 

end of the 12th week. Your uterus is 

about the size of a grapefruit. Your 

1 

chances of early miscarriage are less 

after 12 weeks. 

I MPORTANT T HINGS TO 

K NOW 

Abdomen: The part of 

the body in a woman 

that contains her 

intestines, stomach, 

bowels, and uterus. 

Amniotic fluid: The 

fluid that surrounds the 

fetus inside the uterus. 

Amniotic Sac: A thin membrane inside 

the uterus that surrounds the fetus and 

amniotic fluid. This is also called the 

bag of water. 

Care Provider: In this pregnancy guide 

“care provider” will refer to a health 

professional who is licensed to provide 

medical care to pregnant women and 

newborn infants. 

• OB Gyn Medical Doctor 

• Certified Nurse Midwife 

• OB Gyn Nurse Practitioner 

• Family Practice Medical Doctor 

• Pediatric Medical Doctor 

• Pediatric Nurse Practitioner 

Cervix: The lowest part of the uterus 

that opens and shortens for birth. 

Conception: Fertilization – the union of 

the sperm and egg. 

Fetus: The medical word for a developing 

baby in the uterus. The baby is a fetus 

after 8 weeks of development.

Gestation: The age of your unborn 

baby measured in weeks. This is from 

0-42 weeks. 

Miscarriage: The delivery of a baby 

before 20 weeks in pregnancy. A baby 

before 20 weeks cannot live. 

Placenta: The organ that develops inside 

the uterus where the fertilized egg 

starts off. This organ brings the growing 

baby food and oxygen. It also protects 

the baby and the inside of the uterus 

from harmful things. 

Prenatal: The time from conception to 

the birth of your baby. 

Trimester: A block of time during pregnancy 

measured in weeks. Pregnancy is 

divided into 3 trimesters: 

First: 0-14 weeks 

Second: 15-28 weeks 

Third: 29-42 weeks 

Umbilical Cord: The cord connecting the 

fetus to the placenta. 

Uterus: The hollow organ made of 

muscle in a woman’s abdomen. This is 

where a fertilized egg will start growing. 

The egg will bury itself into the lining 

of the uterus. In the first 8 weeks the 

growing baby is called an embryo. 

C HECK- UPS 

In your first trimester you will begin 

regular visits to your doctor or midwife’s 

office. The first visit will usually be 

between 6 and 10 weeks of the pregnancy. 

Prenatal visits give you the chance to 

ask questions and learn about your 

pregnancy. Here are some things that 

you may want to talk about: 

• How does the office work What 

are the hours How do I make 

appointments What do I do when 

the office is closed and I need to 

talk to my care provider 

• What foods should I be eating 

• What things could harm me or 

the baby 

• What activities and exercise can I 

do during pregnancy 

• Is intercourse/sexual activity during 

pregnancy OK 

• What tests will be done in the first 

trimester and what do they mean 

W HAT W ILL H APPEN AT 

M Y C HECK- UPS 

Pregnancy lasts 40 weeks. It starts 

with the date of your last menstrual 

period (LMP). It is divided into 3 

“trimesters.” 

Your prenatal visits to your doctor or 

midwife will be scheduled once a month 

until about 28 weeks. From 28 to 36 weeks 

you may be seen every 2-3 weeks. After 

36 weeks they will want to see you once 

a week or more. 

At your first prenatal visit you will: 

• Set your due date (the date your baby 

might be born). Your care provider 

may suggest an ultrasound to help set 

the due date. Your due date does not 

mean that your baby will be born on 

that day. You might deliver two weeks 

before that date or two weeks after 

that date. 

• Have lab tests such as checking your 

urine and blood. Your care provider 

will do an HIV test. 

• Be asked questions about your health, 

your partner’s health and your family’s 

health (mostly your mother and 

father’s health). 

• Be weighed and have your blood 

pressure checked. 

• Have a vaginal exam to feel your 

uterus to see how your baby is growing 

and have a pap smear. 

2 

Your visits after the first check-up will 

take less time. You will: 

• Be weighed to make sure you are 

gaining weight. 

• Have your urine and blood 

pressure checked. 

• Have the baby’s heart beat checked 

(after 12 weeks). 

• Have time with your doctor, midwife 

or nurse practitioner to talk about 

your health during the last month. 

• Have time to ask questions. 

T EST D ONE IN THE F IRST 

T RIMESTER 

Pregnancy tests 

A blood or urine pregnancy test may 

be done even if you did a pregnancy test 

at home. 

Urine check 

A urine check to see how your kidneys 

are working and for signs of infection. 

Blood tests 

Many things can be checked from the 

blood that is drawn from your arm: 

• Sexually transmitted diseases like 

gonorrhea, syphilis, and HIV 

• Hepatitis (a disease of the liver) 

• Your blood type (A, B, AB, or O) and 

the Rh factor (positive or negative) 

• Anemia (low red blood cells) 

• A rubella (measles) test will show if 

you have had rubella or if you have 

come in contact with someone who 

had rubella. 

• Other testing: Ask your care provider 

about testing for genetic conditions 

such as diabetes, sickle cell anemia 

and cystic fibrosis. 

Pap smear 

Your cervix is the opening to your 

uterus/womb. This test looks for signs 

of cancer cells in the area of your cervix.

Ultrasound 

The ultrasound machine uses sound 

waves to make pictures of the baby. 

Ultrasound can help set your due date 

when it is done in the first trimester. It 

can look at your baby’s growth and the 

placenta. It can also see how many 

babies are in your uterus. There is no 

radiation used with ultrasound. 

WARNING S IGNS 

Call your doctor or midwife if 

any of these things happen: 

• Bright red vaginal bleeding like a 

menstrual period (You might have 

spotting after a vaginal exam, vaginal 

ultrasound or intercourse. A small 

amount of blood after these events 

is normal.) 

• Sharp abdominal pain with your uterus 

becoming very hard (Talk with your 

care provider about sharp pain low in 

your belly that might be tightening of 

ligaments that hold your uterus. This 

is not a warning sign.) 

• Leaking or gushing of fluid from 

your vagina 

• Sudden swelling of hands and face 

• Changes in vision (blurred or dark 

spots in front of your eyes) 

• Severe headache 

• Being very dizzy 

• Swollen, red, painful area on the leg 

(especially the calf area) 

• Pain or burning when you urinate 

• Itching, burning, or pain in the 

vaginal area 

• Vaginal discharge with a strong odor 

• Fever higher than 100.4 (taken by 

mouth) 

• Vomiting for 24 hours or urine that is 

dark yellow or orange 

B ABY 

At the end of the first month your baby 

is smaller than a grain of rice. In the next 

two weeks many of the baby’s organs 

(brain, spinal cord, heart, intestines, 

and stomach) begin to form. The head 

and body begin to form. The heart 

begins to beat about the 25th day 

after conception. 

By the end of the second month, the 

baby begins to look more like a human. 

From the top of the head to the bottom 

of the buttocks your baby is about 

1 1 /4 inch long. Your baby weighs the same 

as an aspirin tablet. Arms, hands, fingers, 

and legs are forming. Most of the 

internal organs are completely formed. 

Eyelids are formed and sealed shut. 

The middle ear is forming for both 

hearing and balance. The head is large 

compared to the rest of the body. The 

baby is beginning to move. 

At the end of the third month, your 

baby is 2 1 /2 to 3 inches long and weighs 

about 1 /2 ounce. The body organs are 

starting to work. Blood is flowing 

through veins and urine is being formed 

in the kidneys. Muscles are growing and 

movements of the arms and legs are 

more frequent. Sex organs are formed 

but it is still hard to tell the sex of the 

baby. 

FATHER/PARTNER 

It is normal for you to have many feelings 

at this time, just like mom. Feeling 

excited, nervous, and afraid all at once 

is normal. Mom will be getting a lot of 

attention and you may feel “left out.” 

A very good way to feel involved and 

important is to go to prenatal visits 

with mom. Read about pregnancy with 

her. Ask her about how she’s feeling and 

what’s happening to her body. 

Mom will need and want to “lean on 

you” for support and encouragement. 

Sometimes the best way to support is 

to “just listen.” Women cope with 

change and stress by talking about it. 

You won’t always have to fix the stress 

by doing something. Listening may give 

her what she needs. 

You might see mom acting a little strange 

at times. One minute she is laughing 

and joking, the next minute she is crying 

and afraid. One minute she is feeling 

sick and the next minute she’s eating a 

full meal. This is normal in pregnancy 

even though it might not make any 

sense to you. 

Our weekly e-newsletter is part of the educational offerings here at Mission. These 

emails include research findings about pregnancy, health and wellness, as well as 

newborn care, child development and breastfeeding. You can also email questions 

or comments to a staff person here at Mission. 

Visit theparentreview.com/missionhealth to sign up. 

• A change in the kicks and movements 

of your baby 

3

S T AYING H EALTHY 

D URING P REGNANCY 

Exposure: 

Do not smoke or expose yourself to 

second-hand smoke. Call Mission’s 

Nicotine Cessation Program at 

213-0291 for help with quitting for you 

or a family member. 

Do not drink alcohol or use street drugs. 

Do not take any medications unless 

you have talked with your care 

provider. 

Do not empty the litter box of a cat. 

Try to stay away from anyone who is ill, 

especially with chicken pox, fifth’s 

disease, measles, and flu. 

Avoid working around toxic chemicals 

or fumes or radiation. Notify the x-ray 

personnel that you are pregnant before 

they take an x-ray. 

Nutrition: 

Do not drink or eat food with caffeine 

such as: colas, coffee, tea 

and chocolate. 

Do not eat raw or undercooked meat 

or soft cheeses or blue-veined cheeses. 

Eat a balanced diet. (See the Nutrition 

Information in this guide.) 

Drink 8 glasses of fluid each day. 

Water, milk or fruit juices are best. 

Take your daily multi-vitamins or a folic 

acid tablets as told by your 

care provider. 

M EDICATIONS FOR PREGNANCY 

*Always consult with healthcare provider before using.* 

Problem: 

Headache 

Sinus Problems/Head Colds 

Cough 

Sore Throat 

Nausea/Vomiting 

Indigestion/Heartburn 

Constipation 

Diarrhea 

Hemorrhoids 

Insomnia 

Medicine: 

Tylenol 2 tablets (regular or extra strength). 

Sudafed, Tylenol Cold, Tylenol Sinus, Dimetapp, Drixoral (do not use for more 

than 3 days), Saline Nose Spray. 

Robitussin (Plain or DM). 

Chloraseptic Spray or sore throat lozenges/cough drops. 

Report fever over 101 degrees. 

Emetrol (if not diabetic), Dramamine (makes you sleepy). 

Antacids (chewable tablets or liquids), Papaya Enzyme Tabs. 

Senekot or Perdiem (vegetable supplement), Colace, Citrical/Metamucil 

(fiber supplements). Do not use a stimulant laxative. 

Immodium AD, Kaopectate, Lomotil. Eat yogurt with live cultures like Dannon 

or Breyers. 

Witch Hazel, Tucks pads, Anusol, Americain, or Nupercain Ointment. 

Benadryl, Tylenol PM. Talk with your care provider before you use these. 

4

Personal Care: 

Brush your teeth twice a day and floss 

once a day. Keep regular check-ups with 

your dentist. 

Wear a shoulder and lap seat belt. 

Do not douche. Call your care provider 

if you have vaginal itching, burning or 

odor with your discharge. 

Sex is considered safe in a normal 

pregnancy. Talk with your care provider 

to make sure it is safe for you. If you have 

more than one sex partner use a condom 

with intercourse. Using a condom 

helps protect mother and baby from 

some sexually transmitted diseases. 

Lifestyle: 

Avoid overheating your body with very 

hot baths or saunas. 

Do light, easy exercise 30 minutes, 3 times 

each week. Walking or swimming are 

the best. 

Don’t sit or stand for long periods of 

time. When taking a car trip, stop every 

1-2 hours to stretch your legs. 

Rest every day. If you work outside the 

home, rest when you come home. 

E XERCISE 

Exercise can help in many 

ways during pregnancy. 

• It can help with 

headache, backache, 

constipation, leg cramps 

and insomnia (trouble sleeping). 

• It can help build strength in your 

muscles and give you more energy for 

pregnancy and birth. 

• It can help with stress. Stress can give 

you headaches, keep you from sleeping, 

make you feel tired, and make you 

feel nervous. 

During pregnancy your muscles relax, 

your balance changes, and you may feel 

more tired. This can affect exercising. 

If you were active before you got pregnant, 

you can continue this exercise. 

If you were not active, start off slowly 

with gentle stretching and walking or 

swimming. 

Things to remember about exercising: 

• Talk with your doctor or midwife 

before you exercise. 

• Drink plenty of water or juice before, 

during and after you exercise. 

• Do not exercise when it is very hot. 

• Stop if you have pain, become dizzy, 

have cramps or have trouble breathing. 

K NOWING Y OUR R IGHTS 

Look into your rights before your 

baby is born. Find out your company’s 

policies on paid or unpaid leave, and if 

your company is covered by the Family 

Medical Leave Act. 

The Family Medical Leave Act 

(FMLA) requires employers with more 

than 50 workers to provide both 

women and men with 12 weeks of 

unpaid leave for the birth or adoption 

of a child. FMLA also covers all public 

agencies, including state, local and 

federal employers, and local schools. 

Another law, The Pregnancy 

Discrimination Act (PDA), requires 

employers with more that 15 workers to 

treat pregnant workers like disabled ones. 

Under this law, if a company provides 

paid leave or job security for an employee 

to have surgery, it must do the same for 

pregnant women. 

Your rights 

To be eligible for FMLA: 

• You work for a company required to 

cover FMLA. 

• You have worked for the employer for 

a total of 12 months. 

• You have worked at least 1,250 hours 

over the past 12 months. 

Your part 

• You must give notice of your plan to 

take family and medical leave at least 

30 days before leave is to begin. 

Upon return to work 

• You must be returned to the original 

job and with same pay. 

• The use of FMLA leave cannot result 

in the loss of earned employee benefits 

or those entitled to before leave. 

F IRST T RIMESTER 

“TO -DO ” LIST: 

Take classes 

✓ We recommend that all first time 

parents take pregnancy, childbirth and 

parenting classes. In Buncombe County, 

classes are available at: 

• Mission Hospital (toll free 877-213-1221, 

local 213-2222) 

• MAHEC’s Birth with the Heart 

(674-8477) 

• Possibly in your care provider’s office 

• With a private teacher in the 

community 

• See page 13 for other community 

classes 

At the end of this section is detailed 

information about classes offered at 

Mission (the cost and when to sign up). 

Your care provider can help you decide 

which may be best for you. 

5

REMEMBER: Sign up early. Classes 

fill up quickly. If it has been over two 

years since you have had a baby we 

recommend that you take a refresher 

childbirth class. 

Buncombe County Health Center offers 

childbirth classes in Spanish. 

Other things to do: 

✓ Fill out your OB Pre-Admission form 

(located at the end of this section). 

Your care provider will send this to 

Mission Hospital. Or, you can 

complete the form online at 

missionhospitals.org/obpreadmission. 

✓ Talk with your employer about time 

off for birth. Talk with your insurance 

company about maternity coverage 

for your doctor and hospital costs. 

✓ If you do not have insurance, call 

213-1508 for information about 

your hospital bill. See “Support 

Services for Pregnant Women” for 

information on pregnancy Medicaid 

and other services (at the end of this 

section). 

✓ Buy or check out a good pregnancy 

book. (See packet and your pregnancy 

guides for lists of books and videos.) 

✓ Enroll in an obedience or refresher 

course for your dog. Commands like 

sit, down, stay and come are helpful. 

R ECOMMENDED R EADING 

Stop by Mission Hospital’s Wellness 

Resource Center, Memorial Campus, 

or call us at 213-8246. We have many of 

these books available for check-out in 

our library. 

A Child is Born by Lennart Nilsson 

Bantam Doubleday Dell Publishing 

Group Inc. 1990 

A New Life by John T. Queenan, M.D. 

Marshall Cavindish, Ltd, 1989 

Having Your Baby, a Guide for African 

American Women by Margaret Williams 

Having Your Baby with a Nurse Midwife 

The American College of Nurse-Midwives 

and Sandra Jacobs 

Nova’s The Miracle of Life video can be 

rented at most video stores or at the 

library. 

Planning Your Pregnancy and Birth, 

3rd Edition 

The American College of Obstetrics 

and Gynecology 

Pregnancy, Childbirth and the Newborn: 

The Complete Guide 

Simpkin, Whalley, and Keppler 

Meadowbrook Press, 2001 

Birth over 35 by Sheila Kittinger 

Birthing from Within by Pam England & 

Rob Horowitz 

While Waiting – A Parents Guidebook by 

George E. Verrilli M.D., F.A.C., O.G. 

and Anne Marie Muesser, Ed.D. 

The Birth Partner by Penny Simkin 

Our Bodies, Ourselves: Pregnancy and 

Birth by Boston Women’s Health 

Collective 

D ID YOU K NOW... 

Fetal alcohol spectrum disorder (FASD) is the most common nonhereditary cause of mental retardation. FASD can 

occur if a pregnant woman drinks at any point during her pregnancy. 

According to the U.S. Department of Health and Human Services, prenatal alcohol exposure has a more devastating 

long-lasting effect on an unborn child than street drugs such as marijuana, cocaine, heroin, and tobacco. Prenatal 

exposure to alcohol may result in any or all of the following: 

• low birth weight • impaired growth • intellectual developmental delays 

• hyperactivity and inattention • sleeping problems • poor feeding 

• excessive crying • organ damage • respiratory problems 

The effects of prenatal alcohol exposure on the brain are permanent and cannot be repaired. 

In school, kids affected by prenatal alcohol exposure may have: 

• learning and behavioral problems • difficulty with mathematical skills 

• difficulty with memory and attention • difficulty with school performance 

• poor impulse control or judgement 

6

N UTRITION H INTS 

F OR M OM 

Even though you are now eating for 

two, you will only need to eat a little 

more food each day 300-500 calories a 

day more. This is about 1 /2 of a peanut 

butter sandwich and milk. Eating 

enough food is very important for your 

baby’s growth. Gaining too much weight 

will make it harder for you to lose the 

weight after the baby is born. Limit foods 

high in sugar and fat. If you are overweight, 

now is not the time to diet. A 

healthy weight gain during pregnancy is 

between 25 and 35 pounds. (Your doctor 

or midwife will tell you what is best 

for you.) Most moms need to gain 3-4 

pounds during the first 3 months and 

about 3-4 pounds each month for the 

rest of the pregnancy. 

R ATE Y OUR D IET 

Circle your answer to each question. Y = Yes, N = No, S = Sometimes 

Y N S I eat two or more servings of vegetables each day (example: 1 /2 cup broccoli, 

1 /2 cup carrots). 

Y N S I eat two or more servings of fruit each day. 

Y N S I eat one serving of foods high in Vitamin A each day (example: carrots, 

spinach, squash, mango). 

Y N S I eat foods high in Vitamin C every day (example: orange, grapefruit, 

tomato, melon, strawberries). 

Y N S I have four glasses of milk or I eat 4 servings of dairy foods (example: 

cheese, yogurt, pudding) each day. 

Y N S I eat at least two servings of lean meat, fish, chicken, turkey, beans, nuts or 

soy foods each day. 

Y N S I eat four or more servings of breads, cereals, pasta and rice each day. 

Y N S I eat whole grains (wheat bread, whole grain cereal). 

It is not necessary to cut down on salt 

unless your doctor tells you to. Drink 

plenty of fluids all during your pregnancy, 

8-10 glasses (8 oz.) daily. Enjoy water, 

fruit and vegetable juices, and milk. 

Avoid caffeine (tea, coffee, colas) and 

soda drinks high in sugar. 

T HE W EIGHT Y OU G AIN 

I N P REGNANCY 

Y N S 

Y N S 

Y N S 

Y N S 

Y N S 

I eat no more than four eggs each week. 

I eat no more than one serving of cake, cookies, pastries, baked goods, or 

candy each day. 

I don’t eat very salty food (example: bacon, pickles, chips). 

I don’t eat lots of fat and oils (example: butter, margarine, salad dressing, 

fried foods). 

I eat breakfast each day. 

4-6 pounds Mother’s body storing fat 

2-3 pounds Mother’s body storing 

extra fluid for pregnancy 

and breastfeeding. This 

is important for the baby. 

1 /2 pound Increase in breast size 

2 pounds Uterus getting bigger 

6-8 pounds Baby 

1 1 /2 pounds Placenta 

20-30 pounds Total weight gain 

Y N S I eat when I am hungry, not when the clock says it’s mealtime. 

Y N S I snack. 

How are you doing 

Give yourself two points for every Y and one point for every S you circled. Add up 

all the points. 

20 to 30 points: Keep it up, you’re eating well. 

17 to 20 points: Pretty good. You’re doing fine, but there’s room for improvement. 

9 to 16 points: Your eating habits need some work, look for ways to improve them. 

8 or less: You need to take better care of yourself and your developing baby. 

Start today! 

7

H EALTHY F OOD C HOICES 

Grains 

(Bread, cereals) 

6-11 servings 

Vegetables 

3-5 servings 

Whole grain breads, tortilla, whole grain cereal, biscuit, pastas, rice, 

6 crackers, pita bread 

Broccoli, spinach, collard greens, sweet potato, cabbage, carrots, green beans 

(wash all fresh vegetables thoroughly) 

Fruit 

2-4 servings 

Milk and Milk Products 

(Cheese, yogurt, etc.) 

4 servings 

Meat and Protein 

(Beans, nuts, fish) 

2-3 servings 

Fruit juices: apple/orange, watermelon, banana, apple, guava, mango, 

strawberries, blueberries 

(wash all fresh vegetables thoroughly) 

Milk, yogurt, cottage cheese, hard cheese, ice cream, pudding, custard 

(avoid unpasturized milk and soft cheeses) 

Meats: pork, beef, chicken, fish, turkey, shellfish, tuna, nuts, peanut butter, canned 

baked beans, dried beans/peas, tofu 

(avoid undercooked or raw meats) 

T IPS TO R EDUCE S TRESS 

1. Exercise. Take a walk during the day. 

2. Talk with your family and friends about your feelings. It is important for them to know how you feel so they can help you. 

3. Get enough sleep. 

4. Eat a well balanced diet. 

5. Think positive. Remember the things that are good in your life. 

6. Take a few deep breaths. This makes you breathe slower and helps your muscles relax. 

7. Count to ten. This makes you stop and relax before you react to the stressful situation. 

8. Take a good stretch. Stretching makes muscles relax and helps you feel less tense. 

9. Massage the tense muscles. The muscles in the back of your neck and upper back usually get tense when you are stressed. 

10. Take warm baths to help you relax. This will help with sleep too. 

11. Do things you find relaxing like listening to music, reading, meditation and prayer. 

12. If you are trying to do too much, learn to say no and slow down. 

8

C OMING TO THE HOSPITAL 

Any time you are coming to the hospital for a test or procedure or for your baby’s birth, enter through Emergency/Trauma 

Entrance on the Memorial Campus. The staff in the Emergency Department will help you get to the area in the hospital 

where you need to go. Park in the Outpatient parking deck on the Biltmore Avenue side of the hospital. 

Family and friends 

Your family and friends can use the parking deck off McDowell Street and enter the hospital through the Visitor Entrance into 

the main lobby. The Information Desk Staff will direct them. 

Day/Evening visiting hours 

For family and friends, these visiting hours are 9:00 am – 8:30 pm. On Mother-Baby, “Quiet Time” from 2:00 – 4:00 pm is 

observed. This quiet time is for the new mom and baby to rest and bond. Fathers or a support person and any big brothers or 

sisters are welcome. 

Keeping moms and babies safe from illness is very important in the first weeks after the birth. For this reason we ask for your 

help with the following: 

1) Big brothers and sisters are welcome to visit on the nursing units. Other children are welcome to visit if they are 14 or older. 

2) All children are to have an adult with them while in the hospital. 

3) Siblings, family and friends need to be free of signs of illness. 

4) All persons are to wash their hands when they arrive and leave the room. 

Night-time visiting hours 

For family and support persons, these visiting hours are 8:30 pm – 5:00 am. For the safety of families and staff, plan to “check in” 

with our security staff. You will go to the main lobby of Mission to register and get a visitor’s badge. 

Unlisted patient 

Medical privacy laws today give hospitalized patients the right to choose whether or not they would like personal information 

available to the public. They can choose to be “listed” or “unlisted” in our patient directory. 

If you decide to be unlisted before your birth, do not tell anyone that you are going to the hospital. 

If someone tries to visit a patient who has chosen to be “unlisted”, Mission Hospital cannot: 

Tell them if the patient is in the hospital 

Give them a room number 

Tell them the patient’s condition, such as critical, serious, fair, etc. 

Deliver mail, flowers or gifts to the room 

*This includes family or the person who brought the patient to the hospital. 

We know that the “unlisted” patient rules can be difficult and we are sorry for any inconvenience; but, we must obey the 

medical privacy laws. 

Smoking/Tobacco Use 

As a community leader in healthy living and to improve the wellness of our patients and staff, Mission is a “tobacco-free” 

environment. This includes hospital rooms, the hallways, the waiting areas, and all hospital property. 

For directions to the Memorial Campus, have family and friends 

visit missionhospitals.org and click on “Maps & Directions.” 

9

D RIVING D IRECTIONS 

Coming from 19/23 (Johnson City and Erwin, TN) 

• Take the I-240 East Expressway (Downtown) exit off of 19/23 

• Get in right hand lane to take the right fork (expressway) 

• Go 1.0 mile and take exit 5B (Charlotte Street) 

• Turn right at the end of the exit ramp onto Charlotte Street 

• Go 0.9 mile (through two lights), and then get into the left hand lane 

• Take a left at the third light onto Biltmore Avenue 

• Get in right hand lane 

• Go 0.7 mile to light at Mission Hospital Memorial Campus (fourth light) 

• Take a right at the light and follow the signs to Emergency Trauma Entrance 

Coming from I-26 (Spartanburg, Tryon) 

• Take exit 1A (Hickory) off of I-26 

• Go 4.4 miles and take exit 50 (South Asheville) 

• Turn left at the light at the end of the ramp 

• Go 0.5 mile, through one light, and get in the left hand lane 

• Turn left at the second light (toward Biltmore Estate) 

• Get in the right hand lane 

• Go 0.9 mile to the light at the Mission Hospital Memorial Campus sign (fourth light) 


Coming from I-40 Eastbound (Knoxville, Sylva) 

• Take exit 50 (South Asheville) off of I-40 

• Turn left at the light at the end of the ramp 

• Go 0.5 mile, through one light, and get in the left hand lane 



• Go 0.9 mile to light at the Mission Hospital Memorial Campus sign (fourth light) 


Coming from I-40 Westbound (Marion, Morganton) 

• Take exit 50-B for Asheville (Biltmore Estate) off of I-40 

• At the end of the ramp you will get into the left lane 

• Go 0.4 mile, through one light 



• Go 0.9 mile to the light at the Mission Hospital Memorial Campus sign (fourth light) 


10

C LASSES: PREGNANCY, CHILDBIRTH AND EARLY PARENTING 

It is necessary to register to be a part of Mission classes and hospital tours. These fill up quickly, so SIGN UP EARLY IN 

YOUR PREGNANCY. To schedule your Mission classes call toll free 877-213-1221 or local 828-213-2222. You will be mailed a 

confirmation and instructions on where to come for the classes. Mission is committed to keeping our classes affordable. 

Receive a 15% discount if you take the following group of classes: ABC’s of Pregnancy, Prepared Childbirth Series or 

Weekend Intensive, Breastfeeding Basics, Beyond Breastfeeding Basics and Safe Babies. 

ABC’s of Pregnancy 

Prenatal Yoga 

Prepared Childbirth 

❑ This is a prenatal class designed for the pregnant Mom and dad or support person to attend 

during mid-pregnancy (between 13 and 24 weeks). This class includes information on physical 

and emotional changes to expect during pregnancy, prevention of premature labor, growth and 

development of baby, pre-admission process, and healthy life style choices for pregnancy. 

Each class is 3 hours long. Cost $15.00. 

Date: __________________ Time: __________________ Location: ___________________________ 

❑ Practicing yoga during pregnancy encourages relaxation, flexibility, and strength in a gentle and 

non-strenuous way. It helps women learn to trust their bodies and helps them relax into the 

experience of childbirth. Each class will include breathwork, body awareness, postures, guided 

imagery and meditation. The class specializes in gentle, therapeutic and restorative yoga. 

(Written approval from the woman’s health provider is required to participate in this 

class). Call 828-213-8246 for more information or 213-2222 to register. 


❑ This six-week series is designed to help prepare for the last trimester of pregnancy experience, 

birth process, comfort measures for labor, cesarean birth, recovery following childbirth, various 

breathing and relaxation techniques and basic new born care. Each class is 2 hours long. Start 

this class between 30 weeks and 32 weeks. A hospital tour is included. Also available at our 

South Asheville location at the Biltmore Park YMCA. Cost $80.00. 


Weekend Prepared 

Childbirth 

❑ This intense weekend class is designed for couples who have challenging work schedules. This class 

focuses on the birth process, comfort measures for birthing, cesarean birth, recovery after birth and 

basic early new born care. Take this class between 32 weeks and 36 weeks. A hospital tour is 

included. Meets Saturday, 1-6 pm; Sunday, 1-6 pm. Cost $85.00. 


Refresher 

Childbirth 

Marvelous Multiples 

Cesarean Birth 

❑ Designed for those who have already completed a childbirth series and are having another child. 

This one-time, 4-hour class is offered once each month. A hospital tour is included. Cost $30.00. 


❑ A 4-week Prepared Childbirth Series for families expecting twins/triplets. Our classes are based 

on a nationally recognized curriculum from Marvelous Multiples Inc. Information about 

pregnancy, childbirth and adjustment after the babies are home is included. An excellent 

opportunity to receive support and meet other families during this unique childbearing 

experience. Start this class by 20 weeks into your pregnancy. A hospital tour is included. 

Cost $40.00. 


❑ This one-time, 3-hour class is for families who are scheduling a cesarean birth. Included in this 

class is information about surgery, comfort measures, family bonding and breastfeeding. $20.00. 


11

Hospital Tour 

❑ This tour is for the pregnant mother, dad or support person and will include areas that will care 

for mother and baby. It is designed for those who do not attend a Mission prepared childbirth 

class. WE ASK THAT CHILDREN NOT ATTEND THE TOUR WITH YOU. No Charge. 

Call 213-2222. 


Safe Babies 

❑ Everyone involved in caring for your baby should plan to attend this 3-hour class based on the 

American Heart Association general child safety recommendationS CPR and rescue breathing is 

demonstrated. The cost is $20.00 per couple. Other family members may come for a fee of $10.00 

per person. 


Breastfeeding Basics 

❑ This 2-hour class, taught by a certified lactation educator, helps prepare you for breastfeeding. 

Dad or a support person is also encouraged to attend. This one-time class is offered on Tuesdays 

at Mission’s WNC Breastfeeding Center and at our South Asheville location at the Biltmore Park 

YMCA. Includes information about benefits, techniques, resources and support. Cost $15.00. 


Working Moms and 

Breastfeeding 

❑ This 2-hour class, taught by a certified lactation educator, covers breastfeeding during the first 

year, pumping and storing milk and weaning. Mothers would benefit from taking this class 

before or after their birth. Cost $10.00. 


Sibling Class 

❑ “My Mom’s Having a Baby” is designed for children ages 3-8. Children learn about having a new 

baby in their home. Call the Health Adventure, 254-6373 to register for this free 45-minute class 

offered twice each month on Monday afternoons. A hospital tour is included. 


Older Sibling 

Classes 

❑ This free 1 1 /2 hour class is designed for children ages 8 and older. Newborn care, safety, helping 

mom and other interesting topics are discussed. A hospital tour is also included. 


Mommy & Me 

❑ There are two free outings for new moms and babies. Interesting topics are discussed each week, a 

certified instructor offers mom and baby exercise. Come join the fun and meet other new mothers. 

Locations: 

Reuter Family YMCA (Biltmore Park), in Mission’s Wellness Resource Center, on Tuesdays 

Woodfin YMCA on Mondays 

To register, please call 213-8098. 


Toddler Fun 

❑ This free outing includes 45 minutes of structured play including songs, stories, sign language, 

Spanish, and much more. 

Locations: 

Reuter Family YMCA (Biltmore Park), in Mission’s Wellness Resource Center, on Tuesdays 

Woodfin YMCA on Mondays 

To register, please call 213-8098. 


12

O THER RESOURCES AND HELPFUL TELEPHONE NUMBERS 

Mission’s Wellness Resource Center, Memorial Campus 213-8246 

Books, videos and magazines available for anyone to borrow. The prenatal section includes selections covering prenatal care, 

birthing options, breastfeeding, infant care, parenting, child safety, family relationships and much more! 

Other Mission Services 

Other Area Resources 

One Call Scheduling Toll Free 877-213-1221 Local 213-2222 

Scheduling childbirth/parenting classes 

Hospital Registration/Financial Counselors 213-1508 

Questions about pre-admission to Mission Hospital, hospital 

expenses and payment options 

Safe Kids 213-5548 

Car seat safety and injury prevention 

Western NC Breastfeeding Center 213-1103 

Breastfeeding support including appointments with lactation 

consultants and breast pump rentals 

Mommy & Me/Toddler Fun 213-2222 

A free education and support group for new moms, including 

Mom and Baby Yoga 

Pregnancy Loss Support 213-8246 

or 213-0369 

Counseling or group support for families who have 

experienced miscarriage, stillbirth or death of a new baby 

(up to 1 yr. of life) 

Pregnancy Massage 213-8250 

Certified pregnancy massage therapists available through the 

Women’s Resource Center 

Prenatal Yoga 213-2222 

Certified prenatal yoga instructor leading classes at the 

Women’s Resource Center 

Stop Smoking: Nicotine Cessation Program 213-5527 

Education and support for nicotine dependence. Fee charged 

on a sliding scale based on income. Scholarships are available. 

Diabetes and Health Education Center 213-4700 

Counseling and support for pregnant women with diabetes 

Fullerton Genetics Center 213-0022 

Resource and counseling for genetic disorders (See “Along the 

Way: Second Trimester Pregnancy Guide” for more 

information) 

Family Support Network of Western NC 213-0033 

or 1-888-810-2800 Ext.2 

Support and education for families of children with special 

needs (See “Support Services for Pregnant Women” for more 

information) 

13 

GENERAL INFORMATION 

Asheville Area Pregnancy, Childbirth, Parenting 

Resources Brochure: Listing of Resources for Doulas, 

Pregnancy Massage Threapists, Prenatal and Postpartum 

Exercise and Yoga, Postpartum/Home Services, Webster 

Certified Chiropractors, Midwifery Services, Community 

Childbirth Classes (Bradley method, Lamaze method). 

Ask your Care Provider for a copy of this brochure. 

Buncombe County Community Services 211 

24-hr. services for finding emergency assistance with housing 

needs, substance abuse, etc. 

CHILDBIRTH AND PARENTING EDUCATION/ 

SUPPORT 

Empowerd Birthing 333-0598 

Prepared Childbirth (Burnsville, Yancey Co.) 678-9797 

Lisa Goldstein, CPM, CNM 

Childbirth Classes (Blue Ridge Regional Hospital, 

Yancey Co.) 766-1581 

Parenting/Breastfeeding (Haywood Co.) 452-8440 

Haywood Regional Fitness Center 

Mountain Area Child and Family Center 298-0808 

(See “Support Services for Pregnant Women” for more 

information) 

Madison Co. Health Dept. 649-3531 

Beginning With Birth 777-8899 

Holistic childbirth preparation 

Hypnobirthing: Morgan Method 777-8899 

Project NAF (Nuturing Asheville Families) 776-1428 

Education and support for African American families during 

pregnancy through the first year of life. projectnaf01@cs.com 

This is Not What I Expected 213-8241 

Support for women experiencing pregnancy/postpartum 

depression/anxiety 

Parenting Education/Skills Training 254-2000 Ext. 101 

Interactive 6-week session, “Becoming a Love and Logic 

Parent.” Learn strategies/techniques to increase parenting 

skills, decrease crisis situations, strengthen families, and 

facilitate raising safe, healthy, motivated children. Offered on 

an ongoing basis. No fee.

4th Trimester Family Center 337-8630 

Resources/support bringing parents together; 

fathers brunch every week for new dads 

Gentle Touch Parenting & Infant Massage 255-5648 

Emma@GentleTouchParent-Child.com 

La Leche League 628-4438 or 1-800-525-3243 

Mom to mom breastfeeding support/group support 

NC Pregnancy Exposure Risk Line 1-800-532-6302 

Education/counseling related to exposure risks in pregnancy 

BUNCOMBE COUNTY HEALTH CENTER 

Birth with the Heart Childbirth Education 674-8477 

Childbirth Preparation Classes (Spanish) 231-9337 

6-week series, daytime (Laura Begal, CCE) 

Breastfeeding Program 250-5172 

Education/support/pump rentals 

WIC Registration 250-5170 

CHILD CARE 

Mountain Child Care Connections 252-5955 

Information and listings of childcare or 1-877-752-5955 

facilities in Buncombe and surrounding counties 

DOMESTIC/FAMILY VIOLENCE 

Helpmate (Buncombe County) 254-0516 

24-hr. crisis help line/housing, etc. 

Henderson Co. Family Violence - Mainstay 693-3840 

Yancey County Family Violence Coalition 682-0056 

Madison County Family Violence - 649-2446 

My Sister’s Place 

McDowell County Family Violence 652-6150 

Child Abuse Prevention Services 254-2000 

Counseling for abused children/families. Crisis intervention, 

assessment, and counseling/therapy services to abused children 

and families. Assists children in dealing with abuse and 

ways it may effect their lives. No fee. 

ADOPTION SUPPORT/SINGLE PARENTING 

Asheville Pregnancy Support Services 252-1306 

(See “Support Services for Pregnant Women” 

for more information) 

Bethany Christian Services 651-8600 

National Safe Haven Program 1-888-510-2229 

or local 271-228-7033 

Don’t Abandon Your Newborn Baby 

Take your newborn to any community hospital Emergency 

Department or any community firehouse. You will not have 

to answer any questions...Your secret and your newborn 

will be safe. 

WOMEN’S HEATH 

Treatment, Healing, & Education Center for 

Disordered Eating 337-4685 

Education/support for women with bullimia, anorexia, etc. 

Womens’ Wellness & Education Center 333-0598 

Massage therapy, accupuncture, trauma & postpartum therapist, 

yoga, mom/baby classes, childbirth classes 

DOULAS 

Birth Doula Services 

A birth doula provides continuous physical, emotional and 

informational support to women and their birth partners 

during labor and birth. 

Postpartum or Home Doula Services 

A postpartum or home doula provides care for pregnant 

women on bedrest and/or after the baby is born. Home doula 

care may include breastfeeding assistance, light housework, 

general child care, laundry, and running errands. 

DAMA (Doula Association of the Mountain Area) 233-5500 

wncdoulas.com 

Asheville Doula Services 275-1959 

Peaceful Beginning Doula Services 258-3327 

Nurture Postpartum Doula Services 778-4958 

DIAPER SERVICE 

Smarty Pants 684-7254 

smartypantsdiaper.com 

Busy Bottoms 713-7293 

Helpful Websites 

Mission Hospital 

missionhospitals.org 

Mission Women’s Health missionwomen.org 

DAMA 

wncdoulas.com 

La Leche League 

llli.org 

Childbirth Connection 

childbirthconnection.org 

American Academy 

of Pediatrics 

aap.org 

American College of Obstetricians 

and Gynecologists 

acog.org 

American Academy of 

Family Physicians 

aafp.org 

American College of 

Nurse Midwives 

acnm.org 

Mothering Support 

MOPS.org 

Postpartum Depression 

PPDSupport.org 

Pet Preparation for New Baby familypaws.com 

livingwithkidsanddogs.com 

Breastfeeding 

kellymom.com 

New Dad Support 

newdads.com 

Birth/Parenting 

lamazeinternational.com

S UPPORT S ERVICES FOR P REGNANT W OMEN 

Program How do we qualify Where do we apply 

Medicaid for Pregnant Women (MPW) 

This state program pays for the health 

care of low-income pregnant women. 

There is a process to qualify based on the income of those 

in your home. 

Call for an appointment. See listing. ➔ 

The office will let you know what information you will 

need to have for the application. 

For final approval for Medicaid you will need a letter from 

your doctor or midwife stating the date your baby is due to 

be born. 

Pregnant women with insurance may also be able to get 

MPW. If you are not able to get MPW, the Department of 

Social Services may know of other programs to help you. 

• Women getting prenatal care with Mountain Area Health Center 

(MAHEC) Women’s Health Clinic. Apply at DSS, downtown on 

Coxe Avenue or call 250-5500. 

• Women getting prenatal care at the Buncombe County Health Center 

can obtain a mail-in application from the DSS access unit. 

• Women getting prenatal care in a private practice or MAHEC Family 

Practice apply at the Department of Social Services (DSS) downtown 

on Coxe Avenue, 250-5500. 

• Women living outside of Buncombe County call the local Department of 

Social Services or county Health Department. 

Women, Infants and Children (WIC) 

This free government program is set up 

to help get healthy food to low income 

families with: 

• Pregnant women 

• Women after delivery 

• Breastfeeding women 

• Infants 

• Children up to the age of 5 

Complete an application at the Buncombe County Health 

Center. Monday-Friday 8:30am-4:00pm. 

Bring the following: 

• Identification: (Only one of these is needed) Valid 

driver’s license, Social Security Card, current work/school 

ID, birth certificate, immunization record, health record. 

• Residence: (Only one of these is needed) Recent water, 

electric, cable, gas, or telephone bill, recent rental or 

mortgage agreement. 

• Income: (Bring information for all household members) 

Medicaid card (or Work First eligibility), Letter of Food 

Stamps certification. If above does not apply, bring 

recent paycheck stubs, or self-employed tax return. 

• Women who get prenatal care at a private practice, the Buncombe 

County Health Center or MAHEC Family Practice apply: 

Buncombe County Health Center, 250-5000 

Downtown, Woodfin Street 

Monday – Friday 8:30am - 4:00pm 

• For those who get prenatal care with the MAHEC Women’s Health 

Center, at the first office visit you will be checked to see if you qualify 

and then can sign up for the program at the center. You will be asked 

about the foods you eat and given advice from a counselor. 


Social Services or county Health Department. 

Baby Love 

(Maternity Care Coordinator) This NC 

program helps pregnant women find early 

prenatal care and care after the baby’s 

birth. Help is provided with: 

• Making medical appointments 

• Education and support 

• Getting transportation 

• Childbirth and parenting classes 

• Childcare and housing 

• Referral to other programs 

These services are for women with Medicaid, however 

they are also open to other qualifying pregnant women. 

Contact Buncombe County Health Center or MAHEC 

Women’s Health Center for information. 

There is no charge for this program. 

• If you are receiving care at the Buncombe County Health Center or 

MAHEC Women’s Health Center: 

Ask to see a Maternity Care Coordinator or Baby Love Worker 

• If you are receiving care at a private practice or MAHEC Family Practice 

Call 250-5299 

or 

Your care provider can make a referral for you 


Social Services or county Health Department.

Program How do we qualify Where do we apply 

Home Visiting Nursing Services 

Registered Nurses visit your home during 

pregnancy and/or after birth. Services 

include checking for health problems, 

education, and support. 

Your health care provider must request these services. 

Medicaid will cover these services. 

Some private insurance plans will pay for these services 

for high risk pregnancies. 

Through your health care provider’s office or clinic. 

Child Service Coordination (CSC) 

This free NC program helps families with 

children (birth to 5 years) get support and 

services for raising healthy children. 

Services include: 

For information, contact them at 250-5299. 

Your Maternity Care Coordinator can help you start this program. 

Women or children who are in private practice call 250-5299. Your 

care provider or the hospital social worker can make a referral for you. 

• Developmental screening 

• Information for child’s health needs 

• Parenting education 

• Support in working with other programs 

• Family support 

O THER F REE FAMILY S UPPORT P R OGRAMS 

Asheville Pregnancy Family Support Project NAF Mountain Area Child and Family 

Support Services Network of WNC (Nurturing Asheville Area Families) Center Pregnant Moms Program 

This is a Christian outreach 

ministry to help women whose 

pregnancies may be a personal 

crisis and to help families and 

the father of the child. It is 

designed to help them prepare 

for birth and parenting. They 

also help mothers with maternity 

clothes and supplies like diapers, 

clothes, etc. 

Contact them at 828-252-1306. 

A free outreach program designed to enhance 

the lives of children with special needs by: 

• Providing support and education for family 

members 

• Parent to parent support and 

encouragement 

• Providing resources for families 

• Designing and coordinating the delivery 

of services 

Receive a quarterly newsletter and community 

education programs through Project SPEAK 

Contact them at 828-213-0033 or 

1-888-810-2800 ext. 2. 

This is an outreach program of Mt. 

Zion Community Development, Inc. 

serving African American families by 

providing: 

• Personal support during pregnancy 

• Help getting child care, medical 

appointments, and transportation 

• Personal parenting support during 

the child’s first year 

Contact them at 828-253-1610. 

This Early Head Start Program helps pregnant 

moms find the services and information they need. 

These include home visits, pregnancy education, 

and support. Education also includes infant/child 

development. They will work with the family 

until the child is age three. Childcare at the 

Center is provided when space is available. 

Contact them at 828-298-0808.

OB PRE-REGISTRATION F ORM ( OR REGISTER ONLINE AT MISSIONHOSPITALS. ORG) 

Please complete this form and return to your care provider’s staff or mail to the address below. Or complete the form online 

at missionhospitals.org/obpreadmission. If you have questions, call 828-213-1508. Important: Please include an expected 

delivery date (see below). 

Patient’s Name:______________________________________________ Date of Birth: _______________ SS#: _________________________ Race: _____ 

Marital Status: ___________________________ Spouse’s Name: ___________________________________________________________________________ 

Home Address: ______________________________________________ City: _____________________________ State: _____________ Zip: ____________ 

Home Telephone: _________________________ Work Phone Number: ________________________ County of Residence: _________________________ 

Occupation: _______________________________________ Employer: ______________________________________________________________________ 

Work Address: _______________________________________________City: _____________________________ State: _____________ Zip: _____________ 

Emergency Information: (Whom should we contact in case of an emergency) 

Name:______________________________________________________ Relationship to you: ______________________Telephone: ___________________ 

Address:____________________________________________________ City:______________________________ State: _____________ Zip: _____________ 

Responsible Party (if you are 18 years or older you are responsible for your account) 

If Responsible Party information is the same as patient information, please check here: ❑ 

Responsible Party Name: ______________________________________ SS #: ____________________________ Relationship: _______________________ 

Address:_____________________________________________________ City:_____________________________ State: _____________ Zip:_____________ 

Home Telephone: _____________________________________________ Work Telephone: _____________________________________________________ 

Insurance Information (Please bring insurance cards when you come to the hospital) 

Do you have insurance coverage Yes _____ No_____ Medicaid _____ Health Choice _____ 

If you have insurance, contact them as soon as you know you are pregnant to see if they need more information. 

Primary Insurance 

Company Name: Address: Telephone: 

Subscriber ID#: Group #: Insured Name: Insured Birthdate: 

Insured Relationship to you: Insured SS#: PreCert Telephone: 

Occupational Information 

Primary Insured Employer: 

Employment Status: 

Work Address: City: State: Zip: Telephone: 

Secondary Insurance 

Company Name: Address: Telephone: 

Subscriber ID#: Group #: Insured Name: Insured Birthdate: 

Insured Relationship to you: Insured SS#: PreCert Telephone: 

Occupational Information 

Primary Insured Employer: 

Employment Status: 

Work Address: City: State: Zip: Telephone: 

Additional Information: 

Have you ever been a patient at Mission: ❑ yes ❑ no 

Under what name(s): 

Please mail form to: 

Mission Patient Accounting 

950 Hendersonville Road 

Asheville, NC 28803 

Must have information: 

Attention: Pre OB 

Expected Delivery Date: 

Obstetrical Provider’s Name: 

Copy of Insurance Card(s) (front and back)

Along 

TheWay

Second 

Trimester 




AlongTheWay 

M OM 

12 to 18 weeks 

During this time your body will be 

changing so that others will notice you 

are pregnant. Your breasts continue to 

change. You may notice a dark line 

forming in your skin from your upper 

abdomen to your pelvis. You may need 

to start wearing maternity clothes. 

Some mothers wonder if they are “going 

crazy” because they can’t remember 

things. Having trouble thinking or 

forgetting things is common. Your 

baby’s heart beat can be heard through 

your abdomen. Your doctor or midwife 

will be listening each visit. Most of the 

early pregnancy discomforts will start 

going away during this time. 


You will start to feel movement of your 

baby between 16 and 22 weeks. These 

movements may start as flutters and then 

feel stronger. The first clear movements 

are known as “quickening.” Your breasts 

are making “colostrum” at this time. 

This is a clear or yellowish fluid that may 

leak from your nipples. 


This is when you and others may see 

even more changes in your body. Your 

baby is growing in size and your belly is 

clearly growing in size because of this. 

The fundus (top of your uterus) will be 

above your belly button. Your feet and 

ankles may seem “puffy” at the end of 

the day. You may feel sharp pains below 

your belly button and off to one side. 

This can happen when you roll over in 

bed or stand up quickly. These are the 

ligaments attached to the outside of 

your uterus and pelvis tightening up. 

The ligaments try to keep your uterus 

from moving in your abdomen. Other 

changes in your body may become a 

challenge to deal with. (See the insert 

with this guide for more information.) 

You will feel your baby move most of 

the time. Movements may feel low or 

high in your abdomen depending on the 

position of your baby. You may feel 

like you are “hot” no matter what the 

temperature is. 

I MPORTANT 

T HINGS TO K NOW 

Braxton Hicks Contractions: The uterus is 

a muscle. Muscles are made to move 

(get tight then get soft). When the 

uterus tightens it is called a contraction. 

You have contractions as soon as you 

get pregnant. Most women don’t feel 

contractions until the 6th or 7th month. 

These “Braxton Hicks” contractions 

during pregnancy are normal. They 

keep the uterus strong. 

Colostrum: The first milk made by the 

breast. This milk is yellowish and may 

leak from the breast during pregnancy. 

Doula: A person trained to help a mother 

and her partner during labor and birth. 

She can help with ideas for dealing with 

pain in labor. A doula can help with 

massage, breathing and encouragement. 

She will show the partner how to help 

19 

the mother. (See www.dona.org for 

more information.) 

Fundus: The top of the uterus. As your 

baby grows, your uterus gets bigger. 

Your care provider can feel your uterus 

through your abdomen. They will 

measure the size of the uterus by 

measuring from the pubic bone to the 

top of the uterus (fundus). 

Genes/Genetics: Genes are the instructions 

that tell our bodies how to grow and 

develop properly (the way they are 

supposed to). For example, they tell us 

what our eye color will be and how tall 

we will be. Sometimes a mistake can 

happen in those instructions that might 

cause a problem or birth defect. Some 

of these problems can be passed in the 

genes you get from your parents. Other 

problems can happen by chance. 

High Risk Pregnancy: Some women have 

health problems before they get pregnant. 

Others have problems that start 

after they become pregnant. The problem 

could mean the doctor will need 

to watch you and your baby more 

closely. You may need 

to see a doctor who 

has special training 

(Maternal Fetal 

Medicine Specialist). 

Indigestion “Heartburn”: When the food 

and fluids of the stomach back up into 

the esophagus (the tube from your 

mouth to your stomach). This may burn 

or feel like a lot of pressure in your 

chest and neck.

Ligaments of the uterus: There are 

ligaments attached to the outside of the 

uterus and your body. They keep the 

uterus from moving around in the 

abdomen. If the ligament stretches too 

quickly it can cause pain in the low 

belly. The pain is usually on the left or 

right side below the belly button. 

Pelvic floor muscle/Kegel exercise: Your 

body has muscles that hold your baby, 

uterus, bladder and intestines up 

inside. These are called the pelvic floor 

muscles. Kegel exercises help those 

muscles stay strong. 

To do a Kegel: Tighten your bottom like 

you are trying to stop your urine from 

coming out. Hold these muscles tight 

for 5 seconds. If you do this 20-30 times 

a day you will feel better. It can help 

keep urine from leaking when you cough 

or sneeze. It will also help your muscles 

work better when you are birthing. 

Quickening: The first movements of the 

baby that the mother feels. Movement 

is usually felt between 16 and 22 weeks. 

Vulva: The female genitals that are 

covered with pubic hair. 

W HAT W ILL H APPEN AT 

M Y C HECK- UPS 

• After about 12 weeks, they will start 

listening to your baby’s heartbeat. 

• They will ask you to watch for first 

movements of the baby. Try to 

remember the date. 

• The following tests may be offered 

or suggested: 


Alpha-fetoprotein (AFP or Triple Screen): 

A blood test that screens for 

problems with the spinal cord or 

other chromosomal problems like 

Down’s syndrome. 

Amniocentesis: A test of amniotic fluid 

that can tell about genetic problems. 


Ultrasound: A test that uses sound 

waves through the abdomen of the 

mother to make a picture of the baby. 

It can tell how many babies are in the 

uterus, how the baby is growing and 

how the placenta is working. 


O’Sullivan: A blood test to look at the 

sugar in your blood. If your blood 

sugar is too high, a GTT (3 hour 

Glucose Tolerance Test) will be done. 

These tests check for diabetes in 

pregnancy (Gestational Diabetes). 

Some things you might want to talk 

about with your care provider at 

your prenatal check-ups: 

1. What do I need to know 

about traveling 

2. Am I at risk for preterm labor 

3. How can I have a healthier pregnancy 

4. Are there classes I should take 

5. Are there books or videos I should get 

6. Can I try to have a vaginal birth if I 

already had a cesarean birth What 

do I need to know 

7. Do you suggest using a doula for help 

in labor 

8. Are there medical problems in our 

families (mine and my partner’s) that 

should be checked out by the Fullerton 

Genetics Center 

Examples: 

- Sickle cell anemia 

- Cystic fibrosis 

- Muscular dystrophy 

- Birth defects (cleft palate, heart 

defects, spina bifida) 

- Mental retardation 

- Two or more unexplained 

miscarriages 

20 

9. Are the following safe during 

pregnancy: 

- Herbs 

- Homeopathics 

- Chiropractic Care 

- Pregnancy Massage 

- Spas (hot tubs) 

B ABY 

At the end of your fourth month your 

baby has grown to about 6 inches and 

weighs about 5 ounces. The sex of your 

baby may be seen by ultrasound. Small 

eyebrows and eye lashes have formed. A 

fine, thin hair (lanugo) covers your baby’s 

body. Your baby begins to look more 

like a human. Fingernails and toenails 

are forming. 

At the end of the fifth month your baby 

has grown very fast and is about 8-12 

inches long and weighs 8 ounces to 1 

pound. A white creamy substance 

(vernix) covers your baby to protect the 

skin. Hair has started to grow on the 

head. Your baby practices swallowing, 

sucking and breathing movements. 

Your baby’s first teeth have formed in 

the gums. The bones inside the ear have 

formed and your baby can hear the 

outside world. 

At the end of the sixth month your 

baby’s eyes begin to open and close. 

The first bowel movement (meconium) 

is forming in the intestines. The lungs 

are formed, but not ready to work on 

their own. The baby can cough and 

hiccup. Sweat glands are forming in the 

skin. Your baby is about 12-14 inches 

and weighs 1 1 /2 to 2 pounds. 


As the early weeks of pregnancy have 

now passed, you may be thinking more 

about the future. You may have the 

following questions:

• How much does it really cost to 

have a baby 

• Do we need help with money or 

maybe services in the community 

• Can I take time off from work when 

the baby is born 

• What things do we need for the baby 

• How do we find a doctor to take care 

of the baby 

• How do we find out about daycare in 

our area 

• Is it O.K. to have sex during pregnancy 

These are important questions to think 

about. Below are some ideas on getting 

answers to these questions. 

• You can talk with our staff at Mission 

about the hospital cost of having a baby. 

Call 213-1508. They can help you make 

payments or answer any questions. 

• Your doctor’s/midwife’s office staff 

can discuss payment for the doctor/ 

midwife fee. This charge includes all 

prenatal care and the fee for delivering 

your baby. 

• Talk with your employer about 

scheduling time off. (See the First 

Trimester Pregnancy Guide for 

information about the Family 

Medical Leave Act (FMLA).) 

• A list of things you will need for your 

baby is in the Third Trimester 

Pregnancy Guide. A great way to get 

these things for less money is to go to 

thrift shops and yard sales. 

• If you need help getting a car seat call 

Safe Kids at 213-5548. 

• See the Third Trimester Pregnancy 

Guide for information about finding 

a baby doctor. 

• Call 250-6700 for Buncombe County 

Child Care Services for a listing of child 

care services in Buncombe County. 

• Unless your doctor has told you 

differently, sex is considered safe 

during pregnancy. 

By 28 weeks mom may be having 

changes that make her uncomfortable. 

Your patience and understanding are 

very important to her. Read and go to 

classes with her to find out ways to help 

her be more comfortable. 

T RAVEL T IPS 

Most women can travel during their 

pregnancy. If you are told you have a 

“high-risk” pregnancy your care provider 

may give you special instructions for 

traveling. The best time for traveling will 

be in the second trimester (weeks 14-28). 

Always talk with your care 

provider before you travel. 

For traveling in a car: 

• Always wear your seat belt. Put the lap 

belt below your tummy, low on your 

hips. Do not wear the lap belt in the 

middle or above your tummy. Put the 

shoulder straps between your breasts. 

For traveling in a car, train or bus: 

• Try not to travel more than 6 hours 

a day. 

• Take pillows for head and low back. 

• Wear loose, comfortable clothes and 

comfortable shoes. 

• Stop every 1-2 hours to walk around. 

• Don’t drink caffeinated drinks. Drink 

lots of water, juice or milk. 

For traveling by plane: 

• Sit in seats that are in front of the 

wings. The ride is less noisy and bumpy. 

• Ask for an aisle seat so you can 

move around. 

• Eat light bland foods before the flight 

and take crackers with you. 

• Wear loose comfortable clothes. Take 

a light jacket or sweater for changes 

in temperature. 

• Don’t drink caffeinated drinks. Drink 

lots of water, juice and milk. 

21 

P REVENTING 

P RETERM L ABOR 

What is a preterm birth 

Any baby born three weeks or more before 

the due date is preterm. When babies 

are born preterm they have a greater 

chance for health problems. These can 

be health problems at the time of birth 

and for the rest of their lives. 

They can have problems: 

• Sucking and digesting their food. 

This could mean they don’t gain 

weight and their body won’t get the 

things it needs for growing. 

• They can have breathing problems 

like asthma and more illnesses like 

pneumonia and bronchitis. 

What is preterm labor 

Preterm labor is uterine contractions 

that can dilate your cervix and cause 

your baby to be born before 37 weeks. 

Preterm labor may not always feel 

the same as labor at 40 weeks. The 

contractions may not feel “painful.” 

Never ignore any of the 

following symptoms: 

• Menstrual-like cramps (constant 

or occasional). 

• Low, dull backache (constant or 

occasional). 

• Pelvic pressure (feels like the baby is 

pushing down) in the vagina. 

• Abdominal cramping (with or 

without diarrhea). 

• Increase or change in vaginal discharge. 

• Uterine contractions every 10 minutes 

or more often. (The contractions may 

not hurt. They may only feel like 

pressure or tightening.) 

• Call your doctor right away if you are 

bleeding or you feel water leaking 

from your vagina.

I think I am having preterm labor. 

What should I do 

1. Stop what you are doing. 

2. Go empty your bladder. 

3. Lie down on your left side for one hour. 

4. Drink 2 to 3 glasses of water or juice 

while you are resting. 

5. Call your care provider if the 

symptoms stay the same or get worse 

during that hour. 

6. Return to a light activity if the 

symptoms go away after that hour. 

Do not do what you were doing when 

the symptoms began! 

7. If the symptoms come back, call 

your care provider. Never ignore your 

symptoms or assume they are not 

important. 

8. Be sure to tell your care provider at 

your next prenatal visit what symptoms 

you had and what you did about them. 

P REVENTING A 

P RETERM B IRTH 

Your care provider cannot always tell 

if you might deliver preterm. ALL 

pregnant women need to do things that 

might prevent a premature baby. 

Here are some tips: 

1. Rest each day. Lie on your sides, not 

on your back. 

2. Avoid standing for long periods. If 

your job requires standing, take 15 

minute breaks in the morning and the 

afternoon. Lie down if possible, or at 

least prop up your feet during your 

breaks. 

3. Avoid heavy lifting. Don’t carry 

groceries, laundry baskets or toddlers 

over 25 pounds. Heavy lifting may 

lead to preterm labor. 

4. Avoid heavy housework. Scrubbing 

floors, washing walls and other 

heavy chores need to be done by 

someone else. 

5. If you have contractions when you 

exercise, STOP exercising until you 

talk with your care provider. 

6. Avoid sitting for long periods. If you 

sit at your job, get up from your desk 

every hour and walk around. 

7. Use a condom with intercourse if you 

are told by your care provider that 

you are at risk for preterm labor.* 

8. If you have more than one sex partner 

during pregnancy, use a condom.* 

9. Brush your teeth 2 times each day 

and floss each day.* 

10. Call your care provider if:* 

- You have pain or burning when 

you urinate. 

- Feel like you have to urinate all 

the time. 

- You have itching, burning or strong 

odor to your vaginal discharge. 

11. A lot of stress during pregnancy can 

cause preterm labor. Stress is different 

for each woman. If you feel that your 

life is too much for you to handle, 

talk with your care provider. They 

may be able to help you find ways to 

deal with stress. 

* Prevents infections that can cause preterm labor. 

You can read the insert in your first 

trimester pregnancy guide for ideas to 

help you handle stress. 

22 

S ECOND T RIMESTER 


Take classes 

✓ Start getting things for you and 

your baby. (See “Mom/Baby Supplies 

for Home” and “Labor/Birth 

Supplies” in the Third Trimester 

Pregnancy Guide.) 

✓ If you have questions about paying 

for your birth, call Mission’s financial 

counselors at 213-1508. They can 

talk with you about ways to make 

payments or answer questions about 

hospital costs. 

✓ Sign up for a prenatal exercise or 

yoga class. (See packet for classes in 

the community.) 

✓ Plan for the care of other children or 

pets while in the hospital. 

✓ Call toll free 877-213-1221, 

local 213-2222 for a hospital tour if 

you are not taking childbirth classes. 

✓ Learn about doulas; find out how 

they can help during labor. Discuss 

using a doula with your husband or 

support person. (See Other Resources in 

the First Trimester Preganancy Guide.) 

✓ Schedule a trip to the vet for your pet 

for an update on needed vaccinations 

and other health screenings. 

✓ Register for a class that teaches you how 

to prepare your dog for the new baby. 

(280-4101) 

✓ Expose your pet (with positive 

reinforcement) to baby sounds, 

smells and new baby equipment. 


Many of these books are available for 

check-out at Mission’s Wellness 

Resource Center, Memorial Campus. 

On Becoming A Family, T. B. Brazelton 

Ourselves As Mothers, Sheila Kitzinger 

Mother: Famous Writers Celebrate Mothers, 

edited by Claudia O’Keefe 

Pregnant Fathers, Jack Helnowritz

I MPORTANT C HANGES I N Y OUR B ODY 

Changes in Your Body 

Eyes: 

A part of the eye gets thicker 

Ligaments stretch 

Nose: 

The lining of the nose swells 

with extra blood 

Breast: 

Glandular tissue grows 

What Happens 

Contact lens irritation 

Your vision is blurred or 

hard to focus 

Stuffy nose, hard to breathe, 

nose bleeds 

Breasts become tender 

Breasts get larger 

What Can I do 

Talk with Pharmacist about eye drops 

After you birth your baby, your eyes will go back to “normal” 

Try Saline (salt) nose drops 

Drink plenty of water 

Use a cold mist vaporizer at home 

The WNC Breastfeeding Center can help you get fitted for 

a bra. Call 213-1103 for an appointment at 34 weeks or later. 

Wear a good bra that fits you well. Consider using a 

maternity bra. Fit the bra on the last hook so there is room 

to expand. Talk with your care provider or the breastfeeding 

specialist at Mission (213-1103) or at Buncombe County 

Health Center (250-6700) if: 

• Your nipples are flat 

• Your nipples are inverted (they go into the breast) 

Stomach and Bowel: 

Digestion slows down 

Indigestion/Heartburn 

Constipation 

Drink 8-10 glasses of water each day 

Eat 3-5 fresh fruits/vegetables each day 

Exercise at least 3 times a week 

Talk with care provider about a fiber supplement 

Ask care provider about using antacids 

Do not lie down after eating for 2 hours 

Eat small meals, 6 each day 

Do not drink when you are eating 

Hemorrhoids/Varicose Veins: 

The extra pressure in a 

woman’s pelvis from the 

uterus and baby causes blood 

to fill up the blood vessels in 

the rectum, vulva, or legs 

Legs: 

Legs cramp especially at night 

(not sure what causes these) 

Pain, itching, and swelling in 

the rectum are hemorrhoids 

Sore, itchy blue veins bulging 

in the genital area or legs are 

varicose veins 

Muscles in the calf tighten 

into a painful cramp 

Drink 8-10 full glasses of fluid each day 

Eat fresh fruits/vegetables each day 

Do Kegel exercises 

Use witch hazel pads to help with swelling 

(Keep the rectal area clean) 

Avoid sitting/standing for long periods of time 

Don’t cross legs when sitting 

Don’t wear knee high stockings, wear support stockings 


Stretch your legs before bed 

Don’t point your toes 

Swelling (edema): 

Your body stores extra fluid, 

especially towards the end of 

pregnancy and in hot weather 

Swelling of feet, ankles, legs, 

hands, face 

With swelling you may have 

pain or itching 


Swim – Cover yourself in water, from the neck down 

Swim several times a week for 30-60 minutes at a time 

Call your care provider if you have rapid swelling in 

your face and hands 

23

S PECIAL S ERVICES 

Being pregnant is not like being sick. 

Most women are healthy during their 

pregnancy. However, things can happen. 

The mother or the baby can have 

health problems that make the pregnancy 

“High Risk.” Mom may need to 

see her care provider more often during 

the pregnancy. She might not be able to 

work or may be put on “bed rest” during 

the pregnancy. 

When something “goes wrong” during 

pregnancy, it can be very hard on the 

mother and her family. 

O UR S PECIAL S ERVICES 

“Our baby died” 

A baby born before 20 weeks is called a 

miscarriage. Babies born this early are not 

able to live. A baby born after 20 weeks 

that has died in the uterus is called a 

stillborn. There are many reasons why a 

miscarriage or stillborn might happen. 

Your care provider may be able to help 

you learn more about what happened. 

If your baby dies any time during your 

pregnancy, it can be very sad and hard 

to deal with. Some women want to be 

alone after their baby dies. Other 

women need to be with people like 

other mothers who have had a baby die. 

Hospital staff or your care provider can 

help you. 

While you are in the hospital, our 

D ID YOU KNOW... 

staff, including chaplains, can help 

comfort you and give spiritual care. 

Your nurse can call the chaplain for you. 

After you go home, Mission Hospital 

offers group support to families whose 

baby has died. This includes 

miscarriage, stillbirth and the death of 

baby during the first year of life. 

A Love Not Forgotten support group 

meets the 2nd and 4th Mondays of each 

month. Call 213-8246 or 213-0369 for 

more information. 

“Does it run in our family” 

Some conditions or birth defects can be 

passed from parent to child. Other birth 

defects can happen by chance. 

The Fullerton Genetics Center helps: 

• Families with health conditions 

caused by a genetic problem 

• Families whose baby has died 

• Families whose baby is born with a 

birth defect 

The staff at the center will look for 

different reasons for the problem. 

They may offer testing to look for a 

genetic cause. If a genetic cause is 

found, they will: 

• Share information to help you 

understand 

• Listen and answer questions 

• Help you find services that might 

be helpful 

Your care provider will set up the visit 

with the center. 

“Something might be wrong” 

When a mother or a baby has a health 

problem, mom may be sent to a special 

doctor. This doctor is called a Maternal 

Fetal Medicine Specialist. This doctor 

is an Ob-Gyn who has special training 

and special equipment for checking 

your baby. You might see this doctor 

one time or several times during your 

pregnancy. You will also have regular 

check-ups with your care provider. Your 

care provider will set up the visit with 

this doctor. 

“I have to go to the hospital” 

Some mothers need care during their 

pregnancy that can only be given in the 

hospital. At Mission, we have a unit set 

up for pregnant mothers who need that 

special care. It is called the Maternal 

Fetal Medicine Unit. The nurses have 

special training in caring for pregnant 

women with special needs. All of the 

rooms are private and family/friends are 

welcome to visit. When a mother has to 

stay for a long time, we encourage her 

to bring things from home that will 

make her room feel less like a “hospital.” 

Special pillows, blankets and pictures of 

other children can help mom feel less 

alone. We have a “day room” on the unit 

where the mothers can meet each other 

and spend time together. 

Preterm labor can happen to any woman. We do not know what causes preterm labor. 

But...new research shows that as many as 45,500 of the 250,000 premature births each year may be caused by gum 

disease. The bacteria P. gingivalis is the main cause of gum infections. This bacteria can get into your blood and travel 

to your uterus. Your body may react to this bacteria by producing a substance called prostaglandin. Prostaglandins may 

be the cause of the premature labor and birth. 

What do you need to do 

✓ See your dentist regularly throughout your pregnancy (if you do not have a dentist, talk with your healthcare provider) 

✓Call your dentist immediately if your gums have: 1) Tenderness 2) Bleeding 3) Swelling 

24

“Our baby needs special care” 

Babies born with health problems 

have a special place to go at Mission 

Hospital. The 51 beds in our Neonatal 

Intensive Care Unit (NICU) are for: 

• Babies born prematurely 

• Babies born with health problems 

• Babies born in other hospitals in 

western North Carolina that need 

special care 

(The only baby we are not able to care 

for is one who needs an operation on 

their heart.) A specially trained staff is 

on hand to care for babies and their 

families 24 hours a day. 

When a baby stays in the NICU it is 

stressful on the parents and their family. 

To help ease their stress: 

• We have 24 hour visitation for parents, 

siblings, and grandparents. 

• The area where each baby stays is set 

up to help parents feel comfortable in 

taking care of their baby. 

• Our nurses encourage parents to 

start taking care of their baby as soon 

as possible. 

• Staff asks parents to help plan their 

baby’s care. 

• As your baby improves and prepares 

to go home we offer private rooms 

for parents and baby to stay together. 

Some of our mothers and fathers, who 

live a long distance from Asheville, 

may need to leave their baby in the 

NICU after mom is discharged from 

the hospital. Traveling back and forth 

from home to the hospital becomes a 

challenge and very tiring. Rather than 

traveling long distances, Mission Hospital 

offers parents a place to stay close by. 

The Lewis Rathbun Center is a 

welcoming, Victorian-style home where 

out-of-town families can stay free of 

charge. Parents can stay in a caring, 

supportive environment while their baby 

receives medical treatment at Mission 

Hospital. Our discharge planners can 

help you make arrangements to stay at 

the Rathbun Center. 

Our NICU staff will help you prepare 

to go home. Individual teaching and 

CPR instructions are just a couple of 

things they will offer to help you feel 

more at ease. 

You can continue getting support & 

education once you are home, from the 

Family Support Network of Western 

N.C. Call 213-0033 or 1-888-810-2800 

ext. 2 for more information. 

P REPARING Y OUR P ET F OR ANEW B ABY 

Five Great Ways to Prepare for Life with Baby 

1. Identify and decrease attention-seeking behaviors such as pawing, barking, jumping or any demanding behavior. 

Learn leadership skills and start these with your dog(s). 

2. Become familiar with subtle signs and body language of dog communication. 

3. Begin a baby-friendly or flexible routine of feeding and activities with your dog and incorporate obedience skills. 

4. Role play with a doll and baby equipment to help gradually expose your dog to these new and exciting items. 

Reward calm and desired behavior. 

5. Identify and begin to use designated “dog zones” in your home, especially in the baby’s room. 

Begin looking to the future, and discuss growth/development and child safety related to your pets. 

Dogs and Stork preparation classes are available in the Asheville area. 

Call 280-4101 or visit www.familypaws.com. 

25

In the 

Home 

Stretch

Third 

Trimester 




In theHomeStretch 

M OM 

You are now in the last 3 months of your 

pregnancy! You may have even more 

changes in your body to cope with: 

• More aching in your back, pelvis, hips, 

and legs 

• Rib pain from the pressure of the baby 

• More pressure on your bladder 

• Stretch marks on your abdomen 

and breasts 

• Trouble getting comfortable when 

you sleep 

• Fatigue (tired most of the time) 

• Swelling in the ankles and feet 

• Indigestion getting worse 

• More uterine contractions that may 

start to feel painful 

• Discomfort when the baby is 

moving a lot 

• Dreams about the baby or birth 

• Constipation 

• “I can’t move – I am so big” 

Trouble: 

- Tying your shoes 

- Getting up off the floor or out of 

the bathtub 

- Getting out of a chair or out of bed 

- Climbing stairs 

Don’t give up! You are 

almost ready to 

give birth. 

A quick reminder of how to be more 

comfortable: 

• Exercise: Yoga, walking and swimming, 

Kegels, pelvic tilts. 

• Eat small meals frequently, don’t drink 

fluids with meals. 

• Drink plenty of water, milk or juice. 

• Think positive thoughts, think about 

seeing your baby soon. 

• Relax – Play gentle music, practice 

slow deep breaths while you relax 

your tight muscles. 

• Prop with lots of pillows – between 

your legs, under your knees, under 

your belly when you lie on your side. 

Use a stool to prop your feet up. 

• Talk to your partner, family, friends or 

care provider about your fears. 

I MPORTANT 

T HINGS TO K NOW 

Cesarean Birth: A cut is made through 

the mother’s abdomen and uterus so 

the baby can be born through her 

abdomen. A cesarean birth could be 

done if: 

• The placenta is in front of the baby 

(previa) 

• The baby is lying sideways in the uterus 

• The baby is breech (coming bottom 

or feet first) 

• The baby is unable to fit through 

your pelvis 

• Genital herpes germ is in the vagina 

• The baby is having trouble getting 

enough oxygen during the labor 

27 

• The umbilical cord has dropped into 

the vagina in front of the baby 

• A mother has had a cesarean birth 

before and would need another one 

Some of these problems happen before 

labor starts and you and your care 

provider might schedule a day for your 

cesarean. Sometimes the problems 

happen during labor. 

Circumcision: When the foreskin that 

covers the head of the penis is removed. 

Informed Consent: Written permission 

for a health care provider to perform a 

procedure or operation. The health care 

provider will explain the procedure or 

operation before the consent is signed. 

Examples of consents you may need to 

sign in the hospital: 

• Epidural - spinal anesthesia 

• Circumcision 

• Vaccinations 

• Cesarean birth 

Contraception (Birth Control): Ways to 

keep a woman from getting pregnant. 

The type of method you use should be 

discussed with your health care provider 

so it works best for you. 

Fetal Kick Counts: A healthy baby moves 

a lot in your uterus. You can help look 

out for your baby’s health by paying 

attention to these movements. Ask 

your health care provider about doing 

fetal kick counts.

Genital Herpes: A sexually transmitted 

germ that can make your baby sick. 

Babies get it from you when they come 

through the vagina (birth canal) during 

birth. Your care provider will watch you 

closely for signs of genital herpes. 

*Relaxation: The ability to release muscle 

tension (make a muscle soft instead of 

tight). If you relax in labor you will: 

• Get less tired 

• Be less afraid, have less stress 

• Have less pain 

*Breathing Patterns: Breathing in a 

rhythm during labor can help a woman 

deal with pain and not tense up the 

muscles of the body. It helps you to not 

hold your breath and gives you something 

to think about instead of pain. 

*Focusing Your Mind: During labor you need 

to think about something other than the 

pain. You need to try to DISTRACT 

yourself. Here are some ideas: 

• Close your eyes and think about a nice 

place (the beach, sitting by a waterfall). 

• Open your eyes and look at a favorite 

picture or a stuffed animal you got 

for the baby. 

• Move around in labor. 

• Listen to music. 

* These skills are best learned in a childbirth 

preparation class. They will also 

work best for you if you practice them 

before birth. 

You will be seeing your care provider 

every two weeks until 36 weeks. After 

36 weeks you will go every week until 

you give birth. In the last weeks, talk 

with your care provider about: 

1. Do I need to count my baby’s kicks 

and movements How do I do this 

2. How will I know when I am in labor 

When do I call my doctor/midwife 

3. How do I find a doctor to care for 

my baby 

4. What are my choices for helping with 

pain in labor 

5. When can we talk about my choices 

for how I want my birth 

6. What do you think about circumcision 

7. What are my choices for contraception 

(birth control) Here are some of the 

choices you can talk about: 

- Hormonal Methods (oral birth 

control pills, Depo-Provera shots, 

birth control skin patches) 

- Barrier Methods (condoms, 

diaphragm, spermicides) 

- IUD (Intrauterine Device) 

- Sterilization (tubal for mom, 

vasectomy for father) 

T ESTS D ONE IN THE 

T HIRD T RIMESTER: 

Group B Strep 

During a vaginal exam your care 

provider will get a sample of your vaginal 

discharge. This will be tested for the 

Group B strep germ. This germ could 

be passed to your baby during birth. 

If the test is positive, you will be given 

antibiotics (medicine) during labor to 

help keep the baby from getting sick. 

Blood Tests: 

Your care provider may need to repeat 

tests for sexually transmitted diseases. 

28 

B ABY 


Your baby now weighs about 3-4 pounds 

and is about 15 inches long. Your baby’s 

lungs are formed but are not ready to 

start working. Calcium is being stored 

in the bones. The brain is growing very 

fast and your baby’s own blood supply is 

being made. 

Remember, to help your baby’s bones, 

brain and blood: 

• Eat 4 dairy foods each day or take 

1200mg of calcium 

• Eat 3 protein foods a day (eggs, meat, 

beans, nuts, soy products, tofu) 

• Eat 3-5 servings of dark green vegetables 

(spinach, collards, mustard greens, 

kale, broccoli, red meat) 

Your baby’s movements may seem 

different. As his brain starts growing, 

his movements change. He will move 

less when sleeping, more when awake. 

His brain grows most in sleeping cycles. 


In the next month your baby will gain 

1-2 pounds and grow 1-2 inches. By the 

end of the month it will be about 5 1 /2 

pounds and be 18 inches long. The lungs 

are almost ready. Your baby’s body is 

making fat to help the baby stay warm 

after the birth. 

K ANGAROO C ARE O R S KIN-TO-SKIN C ONTACT 

“Kangaroo care” is holding a baby against the bare chest of an adult, in skin-to-skin 

contact. The baby wears only a diaper and is covered with a blanket. Over the years 

this parenting technique has been shown to have wonderful benefits for babies. 

Most of the research on the benefits of kangaroo care has been done on premature 

infants in neonatal intensive care units. However, we have also learned that fullterm 

infants benefit as well. These benefits include: 

• Regular beating of the heart 

• Steady, regular breathing 

• More oxygen to baby’s body 

• More sleep time, deeper sleep 

• Faster weight gain 

• Less crying 

• More successful breastfeeding • Faster warming of the baby 

Kangaroo care is recommended to start as soon after birth as possible. It continues for 

several hours a day in the first month of life. You can “kangaroo” your baby a couple 

of hours at a time, a few times each day. For more in-depth information, see below. 

Resources: 

Search terms: 

www.midwiferytoday.com 

kangaroo care 

www.my.clevelandclinic.org 

skin-to-skin contact 

www.kangaroomothercare.com 

www.sciencedaily.com


An average pregnancy is 280 days or 

40 weeks. At the end of this time your 

baby will weigh about 7 1 /2 pounds and 

be 19 –20 inches long. As your baby gets 

ready to be born several things happen: 

• The lanuago (fine hair) goes away 

except for forehead, shoulders and back 

• The vernix (white, cheesy substance 

on the skin) is shed and turns the 

amniotic fluid cloudy 

• Antibodies (made by the body to 

keep your baby from getting sick) are 

being generated 


Mom will be getting more and more 

uncomfortable as the weeks go by. 

Lifting and bending are getting difficult. 

She is getting very tired again. It’s hard 

to sleep because she is uncomfortable 

and she is urinating more at night. 

Try to: 

1. Do more chores around the house, 

e.g., grocery shopping, laundry and 

vacuuming. 

2. Encourage her to rest more, especially 

if she is working outside the home. 

3. Keep your sense of humor. 

4. Don’t take her mood swings personally. 

5. Tell her she’s beautiful and you love her. 

6. Be patient. 

As she gets closer to birthing she may 

start to be more afraid about the birth. 

Things she may worry about: 

• Can I deal with the pain 

• Will I be OK 

• Will the baby be OK 

• Will I have a really long birth 

• Will I be able to do what I plan to do 

during the labor/birth 

You can ask her if she is worried about 

any of these things and ask her to talk 

about her worries with you. If this 

doesn’t help, have her talk to her care 

provider or childbirth teacher. 

T HIRD T RIMESTER 


✓ Pack a bag for labor (see Third 

Trimester Pregnancy Guide). 

✓ Pack a bag for after the birth (see 

Third Trimester Pregnancy Guide). 

✓ If you chose to hire a doula, see the 

Other Resources & Helpful Telephone 

Numbers in the First Trimester 

Pregnancy Guide for contact phone 

numbers. 

✓ Choose a name for your baby for the 

birth certificate and Social Security 

Card. (You will be filling out this 

paperwork in the hospital.) 

✓ Get a car seat and learn how to install 

it with a trained person. (See “Car 

Seat Information” at the end of this 

section for sites and helpful 

telephone numbers.) 

✓ Make meals and freeze them or have 

family/friends plan to bring meals. 

✓ Decide about circumcision. (See this 

Guide for help.) 

✓ Finish getting the things you and 

your baby will need at home. 

✓ Decide who will be with you in labor. 

Talk with them about what you want 

them to do for you in labor and after 

the baby is born. 

✓ Talk with your care provider about 

your plans for birth. Write a plan for 

your birth. (Give one copy to your 

care provider and put another copy in 

your labor bag.) 

29 

✓ Finalize your plans for who will be 

caring for the family pets during and 

after birth. 

✓ Make a plan for introducing your 

baby to the family pets. This can be 

done within days or weeks after birth. 

M Y B ODY IS G ETTING 

R EADY F OR B IRTH 

In the weeks and days before labor 

starts there are signs your body is getting 

ready for the big birthday party: 

• The baby will move down lower into 

your pelvis, away from your rib cage. 

You may notice you can breathe easier, 

you can eat more and you are in the 

bathroom all the time. Your baby has 

DROPPED. 

• Your vaginal discharge may become 

thicker and have a little blood. It may 

be the shape of the end of your finger – 

this is called your MUCUS PLUG. 

• You may have a burst of energy, with a 

strong urge to get things ready for the 

baby. This is a change in your hormones 

and you are NESTING. 

• Your bowel movements may become 

softer, almost like diarrhea. This is a 

hormone change and your body is 

CLEANING OUT YOUR BOWEL. 

This makes more room for the baby 

to be born. 

• You may have contractions that 

are stronger but don’t come in a 

regular pattern. Your UTERUS is 

PRACTICING FOR LABOR. 

• You may lose 2-3 pounds at a check-up.

S T AYING AT H OME 

D URING E ARLY L ABOR 

Unless your care provider has told 

you to come to the hospital, STAY AT 

HOME until your labor is strong. 

What should I be doing at home 

1. If you wake up having mild contractions, 

try to go back to sleep. 

2. If you start labor during the day, 

distract yourself. Do easy chores, go 

to the mall, watch TV, read. 

3. Drink lots of clear liquids (drinks you 

can see through) water, juices, ginger 

ale, Sprite, Koolaid or lemonade. 

4. Eat small light meals – scrambled eggs, 

toast, soups, bagels, baked potatoes, 

pastas, rice, dairy foods. 

5. Rest when you feel tired. 

6. Take long slow walks, followed 

by resting. 

7. Get your bags ready. 

8. Time your contractions every couple 

of hours or when you think they have 

changed. Watch for your contractions 

to get: 

• Regular ( They come at the same 

time, each time. Not 10 minutes 

then 20 minutes then 25 minutes 

apart.) 

• Closer together (Over time the 

contractions will go from being 

15 to 20 minutes apart to 5 to 7 

minutes apart.) 

• Last longer ( The contraction lasts 

45-60 seconds, not 20-30 seconds.) 

• Stronger (You cannot walk or talk 

while you are having a contraction. 

You may start holding your breath 

and need to start using a breathing 

pattern to help you with the pain.) 

When do I call my care provider 

Call your care provider: 

• If this is your first baby and your 

contractions are: 

- 5 minutes apart 

- 60 seconds long 

- You cannot walk during the 

contraction and have to use a 

breathing pattern 

- Contractions have been in this 

pattern for 1-2 hours 

• If your membranes rupture (water 

breaks), tell your care provider: 

- What time your water broke 

- What color your fluid is 

- If you are having any contractions 

• If this is not your first pregnancy and 

you are having regular contractions. 

• If your care provider has asked 

you to call when you think you are 

starting labor. 

• If you are afraid that something 

is not “right.” 

• If you have bright red bleeding like 

your period has started. 

When you call, be ready to tell your 

care provider: 

• How far apart your contractions are 

• How strong they are 

• How long they are lasting 

• If your vaginal discharge has 

some blood 

• If your membranes have ruptured 

and the time they ruptured 

T HINGS I NEED IN 

THE H OSPITAL 

We suggest that you pack two bags for 

the hospital. One for labor and one for 


Remember, when you come to the 

hospital for labor, leave your 

“after the birth” bag in the car until you 

are moved to your room. 

Labor/birth supplies. (Choose any 

you might need for labor. Bring this bag 

to Labor and Delivery.) 

• Spray bottle for misting your face 

• 1-2 pillows (bright colored pillowcase) 

• Lip balm (Chapstick) 

• Snack for support person 

• Money for vending machines 

• iPods, MP3 players, and CD 

players 

• Massage tools and massage oils 

(because of fire codes, candles or 

incense cannot be used) 

• Rice bag for moist, warm heat 

• Warm socks for mom’s feet 

• Camera, film, video camera 

• Focal point (like a small stuffed animal 

or photograph) 

• Birth Care Plan 

• Robe, slippers for walking during labor 

• Toothbrush and toothpaste for mom 

and support person 

• Baby book for foot prints 

• Hair ties/clips 

• Hand-held fan 

• Sweater/sweatshirt for support person. 

Room will be cool for mom’s comfort. 

Remember: Please leave valuable 

jewelry at home. Do not bring large 

sums of money. 

30

After the birth supplies: 

• Nightgown/PJs 

• Underwear 

• Personal Care Items (shampoo, 

toothpaste, etc.) 

• An outfit for the baby and blanket 

• Loose fitting clothing to wear home 

• Health Insurance/Medicaid Card 

• Money for vending machine 

• Favorite snacks (there is a small 

refrigerator in your room) 

• Car seat (If you have this installed 

before your delivery, you do not need 

to bring this to the Mother Baby 

Unit. Tell your nurse you have your 

seat in the car.) 

Please leave these “after birth” 

supplies in your car until you are 

taken to our Mother/Baby Unit 


Bringing Electrical Appliances 

into the Hospital: 

• Inform the admission’s clerk or nurse 

if you want to bring any electrical 

appliance(s) into the hospital or if a 

visitor brings in a device for you. To 

ensure your safety, all such devices 

should be made available for 

inspection by hospital personnel. 

• Small battery-powered devices, such 

as iPods, MP3 players, and CD 

players are generally permitted, as 

long as they do not disturb other 

patients or hospital personnel. Again, 

earphones are recommended. 

Here are some ideas of things 

you will need at home: 

For Baby: 

• Crib or safe place for baby to sleep 

• Sheets for crib/cradle 

• 2-3 receiving blankets 

• Mild soap for bathing 

• Rubbing Alcohol 

• Petroleum Jelly ( Vaseline) 

• Cotton Balls/Swabs 

• 2-week supply of diapers 

• Bag for diapers/supplies when away 

from home 

• 4-6 undershirts 

• 1-2 heavier blankets 

• 4-6 gowns/sleepers 

• 4-6 outfits (weather appropriate) 

Note: You will receive the following 

items from the hospital: 

• Digital thermometer 

• Brush/comb 

• Bulb syringe 

I MPORT ANT D ECISIONS 

F OR M Y B ABY 

During your pregnancy you have made 

some parenting choices that were 

important to your baby, like: 

• Stopping smoking 

• Eating healthy foods 

• Exercising 

• Not drinking alcohol 

As you get closer to the birth there are 

more choices to be made. 

• Should the baby be circumcised 

• What kind of care provider will I use 

for my baby’s care 

• Should I use cloth or disposable diapers 

• Should we put our baby in day care 

How do I find the right kind of day 

care for my baby 

• How do I get my other children 

ready for the new baby 

Talking with your care provider or your 

baby’s care provider is a great way to 

get help with these choices. Reading or 

talking with family and friends is another 

way. Below are a few things you need 

to know. 

Circumcision 

• It is important to talk with your 

baby’s doctor about circumcision. 

You need to know the reasons for 

doing a circumcision or not doing a 

circumcision. After talking with the 

baby’s doctor you can make the best 

choice for your son. 

• You need to decide before the birth. 

The nurses will have you sign a consent 

for the circumcision in the hospital. 

• Medicaid and some insurance 

companies may not pay for 

circumcision. 

• Talk with your baby’s care provider 

about paying for the circumcision. 

• If your baby is circumcised before 

you leave the hospital, your nurses 

can teach you how to take care of 

the circumcision. 

31


Every Week Counts 

Scheduling your baby’s birth too early can cause problems for mom and baby. 

As long as you and your baby are healthy, it is best to stay pregnant for at least 

39 to 40 weeks. 

Your baby needs 39 weeks because: 

• His brain, lungs and liver need this time to fully develop 

• He will be less likely to have problems with his vision or hearing 

• He will have time to gain more weight, so he can stay warm 

• He will be better able to suck, swallow and stay awake to eat 

And, we know that: 

• Due dates may not be exactly right. If you schedule to have your baby and your 

dates are off by one or two weeks, your baby may actually be premature 

• Inducing labor may not work, especially if your body and baby are not ready. 

And then you may need to have a Cesarean birth 

• Cesarean birth can cause problems in future pregnancies 

• Cesarean birth is major surgery……it takes longer to recover and you are more at 

risk for problems, like infections 

Breastfeeding 

Breast milk is the best food for a 

baby. 

• Breast milk is the best food for your 

baby. It helps with physical growth 

and brain development. 

• Babies have less problems with spitting 

up and gas when they are breastfed. 

• Breastfeeding is free. 

• Breast milk is always ready. 

• Breast milk has antibodies that 

protect your baby from germs – 

formula does not. 

• Breastfed babies have fewer health 

problems even when they are older. 

• Breastfeeding mothers have fewer 

occurrences of breast or 

ovarian cancer. 

• Breastfeeding keeps a mother from 

bleeding too much after birth. 

If your doctor is recommending your baby’s delivery before 39 weeks, you may 

want to ask them: 

• Is there a problem with my health or my baby’s health Why do you recommend 

inducing my labor Why do you recommend scheduling a Cesarean 

• Can I wait until I am closer to 39 weeks 

• What risks am I and my baby facing with this earlier delivery 

32

Exclusive breastfeeding recommended 

UNICEF and the World Health Organization (WHO) recommend exclusive 

breastfeeding for the first six months of a baby’s life. This is based on research that 

shows benefits for infant survival and proper growth and development. Breast milk 

provides all the nutrients that an infant needs during the first six months. Exclusive 

breastfeeding may also reduce infant deaths caused by illnesses such as diarrhea and 

pneumonia. Breast milk also helps infants recover from an illness more quickly. 

Rooming In and Feeding Cues 

Mothers and babies should stay together if possible. If your baby stays in your 

room, you actually get more rest. SLEEP WHEN YOUR BABY SLEEPS. Keeping 

mother and baby together really helps breastfeeding. You are more likely to feed 

your baby when they are ready to feed. It has been shown that babies who stays in 

the room are: 

• More content 

• Cry less 

• Develop more regular sleep-wake cycles earlier 

This is because you are seeing your baby’s feeding cues and “sleep-wake” cycles and 

feeding your baby frequently (8-12 feedings within a 24-hour period). This is helpful 

for early and plentiful milk production. 


Formula feeding puts your baby at risk 

for the following health problems. 

Some are chronic or occur 

in adulthood: 

• gastrointestinal disease 

• ear infections 

• asthma 

• allergies 

• respiratory (lung) infections 

• multiple scerlosis 

• obesity 

• sudden infant death syndrome 

(SIDS) 

• some childhood cancers 

• juvenile rheumatoid arthritis 

• diabetes: type 1 & type 2 

• thyroid disease 

• dental cavitities and fluorosis 

• lower IQ (less intelligence) 

Signs That Your Baby is Ready to Feed 

• Sucking on tongue or lips during sleep 

• Sucking on fingers 

• Moving arms and hands toward mouth 

• Fussing or fidgeting while sleeping 

• Turning head from side to side 

33

Baby’s care provider 

• You can choose a pediatrician or a 

family practice doctor to care for 

your baby: 

Pediatrician: Has three years of 

training after medical school. 

This training is focused on children only. 

Family Practice: Has three years of 

training after medical school. This 

training is focused on children 

and adults. 

• Ask your care provider, friends and 

family for names of doctors. 

• Make an appointment to meet the 

doctor before your baby is born 

Here are ideas of things to talk about: 

• What is your training 

• How long have you been in practice 

• What tests for the baby need to be 

done after the birth 

• If my baby is healthy, when 

can we go home 

• Do you have privileges at Mission 

Hospital If not, can you recommend 

a doctor to use at the hospital 

• When should I bring my baby in for 

the first visit 

• Are you in practice by yourself Who 

is on-call when you are not available 

• If I have questions, can I talk with 

someone over the phone 

• What are your office hours 

• How often do you need to see my child 

• What will happen at these check-ups 

• What immunizations does he/she need 

• When should I call if the baby 

seems sick 

• If I have an emergency during office 

hours, what should I do 

• If I have an emergency after office 

hours, what should I do 

• If there is an emergency that needs 

hospital treatment, what should I do 

• What do you think about breastfeeding 

• What do you think about circumcision 

• Who will perform the circumcision 

• How do I pay for circumcision 

Choosing a day care 

If you need day care or you think you 

might need it later, here is some 

important information. 

Finding good care: 

• Ask about the adult-to-child ratio: 

How many children are there for 

each adult 

• Consider group size: Find out how 

many children are in each group/class. 

• Caregiver qualifications: Ask about 

caregiver training and education. 

• Turnover: How long have caregivers 

been at the center or providing care 

in home 

• Accreditation: Find out if the child 

care program has been accredited by 

a national or state organization. 

Other things to consider: 

• Are caregivers trained in CPR and 

First Aid 

• Does the caregiver welcome drop-in 

visits and parent involvement 

• Are there planned activities as well as 

lots of free play time 

• Are materials such as books, art 

supplies and toys available 

• Is there scheduled play outside each day 

• What procedures are in place for 

controlling infections 

• Does the caregiver have references 

• Are there written policies and 

procedures, including emergency plans 

Mountain Child Care Connections is a 

great place to find out about your 

choices. They have information about: 

• All licensed day care centers in 

Buncombe and surrounding counties. 

This includes how each center is rated 

for the activities they offer, training of 

staff, cleanliness, etc. 

• How to choose the best child care for 

your child. 

• Which centers take day care vouchers. 

Call toll-free 877-752-5955 or local 

828-252-5955, or email 

childcareinfo@swcdcinc.org for more 

information. 

34

Preparing other children for a 

new baby 

Ideas for helping other children: 

• Tell your child about his or her birth. 

• Get out pictures of them as a baby. 

• Talk about what the new baby will be 

like – what babies can and can’t do, 

how to hold a baby, etc. 

• Teach your child about waiting. Have 

them practice waiting before the 

baby is born. 

• Help your child get ready to be separated 

from you. Call home from 

another place and let them practice 

talking on the phone with you. 

• Make an audio tape or video of you 

reading a favorite story. 

• Give them small chores to do, so 

they can “help Mom” while you are 

at the hospital. 

• Spend special time during the day, 

especially at bedtime, with your 

older child. 

• Bring a birthday cake to the hospital. 

• Don’t expect too much! It is a stressful 

time for everyone. Be patient! 

These are only a few suggestions you can 

use. Many more are found in the books 

listed in our suggested reading space. 

Another Suggestion: 

Sign up for our Sibling Classes! 

See “Mission Classes” in the First 

Trimester Pregnancy Guide for 

information about younger and older 

sibling classes. These classes include a 

Tour of our Mother/Baby Unit. 


Mom, Dad and I are Having a Baby by The Baby Book by Dr. W. Sears 

Maryann Malecki 

Giving Birth, The Parents Emotions in 

The New Baby at Our House by Joanna Childbirth by Sheila Kitzinger 

Cole 

Your Amazing Newborn by Drs. M. Klaus 

The Nursing Mother Companion by 

& P. Klaus 

Kathleen Hughes 

A New Baby for Us by L. Kugler 

The Complete Book of Breastfeeding 

(includes activities for older siblings) 

Third Edition by Marvin Eiger & 

Sally Wendkos Olds 

The Happiest Baby on the Block by 

Dr. H. Karp 

The Womanly Art of Breastfeeding, 

La Leche League 

Breastfeeding Made Simple: Seven Natural 

Laws for Nursing Mothers 

by Nancy Mohrbach 

H AVE Y OU E VER B EEN S EXUALLY A BUSED 

If you are a survivor of sexual abuse you may have special fears and needs during 

your labor. Mission Hospital’s Survivor Services can help. This program gives you 

the chance to meet with a Labor and Delivery nurse during your pregnancy to 

discuss your special needs, fears or past birth experiences. We can help you 

understand what happens during birth. We then help you create a birth plan that 

addresses your specific needs so that you feel more confident and safe. This care 

plan can be a valuable tool as you work with your doctors and nurses to have a 

birth that leaves you feeling in control and involved in the decisions about 

your care. 

Our visit during your pregnancy will include: 

• A personal tour of our unit and labor rooms. 

• Discussion of a typical labor, vaginal and cesarean delivery. 

• Discussion of your specific concerns about labor and birth. 

• The creation of a Nursing Care Plan that addresses your concerns and 

develops strategies for coping with labor and birth. 

Call 213-8473 for more information, or to make an appointment with our 

Resource Nurse. 

35

D URING YOUR LABOR AND BIRTH 

When you arrive to have your baby, you will be taken to an LDR (Labor, Delivery and Recovery) room. This is where you will 

labor, birth your baby and stay for 1 to 2 hours after the birth. These rooms are set up to make you feel more at home. Items 

needed for your baby’s birth are kept in each room. Each has a private bath and some have large garden-style tubs. These larger 

tubs are for warm, comforting baths during labor (hydrotherapy) and are available on a first come, first serve basis. If you are 

interested, ask about them when you arrive. 

Your nurse will ask you about the birth plans you have discussed with your doctor or midwife. Give her a copy of your birth plan 

if you have one. Talk with the nurse about the things she can do to help and support you. Tell your nurse if you or your support 

person needs an interpreter or if you plan to use a doula for labor support. 

Be sure to tune in to our Relaxation Station, channel 32. The continuous soothing music and relaxing photographs can be a 

great help during and after birth. 

Staying in touch by telephone 

Each room has a phone for local calls. For long distance calls bring a calling card. Collect long distance calls cannot be accepted. 

Cell phones can be used inside your labor room or in the waiting room. Please do not use cell phones in the hallways or in the 

cesarean operating room. Your nurse will remind you of the areas where you can use your cell phone. 

Family and friends during labor 

Mission wants families and friends to be able to support mothers and couples at this very special time. Mothers in labor need to 

be able to save their energy and focus on the birth. To respect the needs, safety and privacy of all moms and families we ask you 

to follow these guidelines: 

• 1 to 4 support persons with you during labor and birth. Choose people who will help support you the most. If you use a doula 

she will count as one of the four persons. Talk with your nurse if you need assistance with other visitors. 

• For safety and privacy, all visitors can wait in the waiting room, not in the hallways. For the health of all mothers and new 

babies, all support persons and visitors need to be in good health. We encourage all family and visitors to wash their hands 

upon entering and leaving a patient room. 

• There may be times when support persons may be asked by the staff, doctor or midwife to leave the room briefly for the 

mother’s privacy and comfort. They may wait in the waiting room during this time. 

• The presence of siblings at a birth can be very important to families. If you desire your other children’s presence during labor 

and birth, please arrange this with your care provider. Big brothers and sisters are welcome to visit on the nursing units. 

Other children are welcome to visit if they are 14 or older. 

Siblings (older brothers and sisters) 

Talk with your doctor or midwife during your office visits about having the baby’s siblings at the birth. If you are thinking about 

having your children at the birth, think about: 

• Will they be a distraction for you during the labor and birth 

• Will they get bored and restless 

• How will they feel seeing you as your labor progresses 

• Who will be the child’s support person (They need to have someone who can accompany them out of the room, etc.) 

36

Our guides for siblings at birth: 

• The baby’s brothers or sisters are welcomed. Other visitors under the age of 14 (cousins or friends) are 

encouraged to visit once mom and baby are home. Remember, all visitors need to be in good health.. 

• Younger siblings (12 years or less) will need another adult with them at all times. This adult can be their “support person.” 

• Please let family and friends know that an adult needs to watch other children at all times. This helps with 

everyone’s safety and privacy during your hospital stay. The waiting area or the mother’s rooms are the places children can 

wait. 

Special classes for siblings are offered in the community and by Mission. See the inserted page Mission Classes or call 828-213- 

2222 for information. 

Pictures 

This is a very special time in your life and we know pictures help save special memories. Talk with your midwife or doctor about 

taking pictures during labor and after the birth. Some staff may not want to be included in your pictures or videos, please ask 

them first. 

Our guides for taking pictures during the birth: 

• Pictures may be taken during labor. We ask that no pictures be taken while the mother is being examined or having procedures 

like starting an IV or an epidural. All video cameras must be handheld. There is not enough space in the room for 

tripods or extra lights. 

• At the time of birth, everyone will be focusing on helping you have a safe birth and healthy baby. Please, no pictures or 

videos during this time. Enjoy this very special moment! 

• In a cesarean birth, still pictures can be taken with your new baby. Your nurse will tell you when you can start taking pictures. 

Guides for a cesarean birth: 

• One support person may be in the room if the mother is awake. If the mother is receiving general anesthesia 

(going to sleep) there is probably an emergency and things will be happening very fast. Staff will be focusing on caring for 

mom and baby. Dad or your support person will wait outside the operating room, where staff can keep them updated. 

• We have specialty staff present in the hospital, ready to take care of your baby’s special needs. 

• We encourage you to bond with your baby during and after the birth in the recovery area. 

• Once you are comfortable in the recovery room, recovery time after a cesarean is about 2 to 3 hours. 

• If you are scheduled for a cesarean birth, please leave all personal belongings in your car until you 

are transferred to the Mother/Baby Unit. 

Your baby’s safety 

When your baby is born, four ID (identification) bracelets will be made. One will be placed on the baby’s wrist and one on the 

ankle. The third is put on mom’s wrist and the fourth is for dad or the main support person. These will be checked anytime the 

staff removes or returns your baby from your room. If a bracelet falls off, let your nurse know right away. 

37

A FTER YOUR BABY’ S BIRTH 

A room for mother and baby 

After your baby is born, you will be taken to a room you will share with your new baby until you go home. Babies stay with their 

mothers at all times. The nurses in this area are skilled in caring for mothers who have given birth and their newborns. They are 

called Mother Baby Nurses. They will help you begin to care for your baby. If your baby has special medical needs, he or she will 

stay in the Neonatal Intensive Care for close observation and specialized care. (See the Second Trimester Pregnancy Guide 

“Along the way” for more information about our neonatal intensive care unit). 

Family and friends 

During the first hour, one family member or friend can help the nurse get you settled. During this time, your other family or friends 

can visit the cafeteria on the second floor or bring your things from the car. We hope each family can enjoy the birth of their baby 

in private, safe and caring surroundings. For this reason, all family and friends are asked to stop at the front desk each time they 

visit on the Mother Baby Unit. Asking guests to check-in helps staff determine if mom is ready for guests. Before your baby is 

born, talk with your family and friends about how much company you would like to have while you are in the hospital. 

• One adult support person (husband, father of the baby, partner, other family member or friend) is welcome to stay with the new 

mom and baby around the clock. A daybed and linens are provided. All other family and friends are welcome 9:00 am – 2:00 pm 

and 4:00 pm – 8:30 pm. 

• “Quiet Time” is given to new moms, babies, fathers or an adult support person, and any new big brothers or sisters from 

2:00 – 4:00 pm. All other family and friends are asked to respect this time for privacy, rest and bonding with the new baby. 

You are welcome to visit our cafeteria or gift shop during this “Quiet Time.” 

• Keeping moms and babies safe from illness is very important in the first weeks after the birth. For this reason, big brothers 

and sisters are welcome to visit on the nursing units, if they do not have signs of illness. Other children are welcome to visit if 

they are 14 or older. Siblings will adjust to a new baby better with good sleep. Please make arrangements for their care at 

home during night time hours. 

• For family and support persons between 8:30 pm - 5:00 am: For the safety of families and staff, please “check-in” with our 

security staff. Go to the main lobby to register and get a visitor’s badge. 

• For the safety, privacy and comfort of all persons, please limit visits to four persons at a time. This does not include the 

father or adult support person or siblings. 

• Door signs indicating mom’s need for privacy and rest are available for hanging on the room door. Please ask your nurse for 

assistance. 

• If you would like to be an unlisted patient for maximum privacy, speak to your nurse as soon as possible. For more 

information about medical privacy laws, see page 9 under “Unlisted Patient.” 

• We encourage all family and friends to wash their hands when arriving and leaving the room. Please do not visit if you have 

signs of illness. 

Breastfeeding 

Breastfeeding is the best food to start your baby’s life. In the last few weeks of your pregnancy think about taking a breastfeeding 

class offered through Mission, the Buncombe County Health Center or other health centers in your area. Our Mother-Baby 

nurses have special training to help you get started with breastfeeding. 

If you or your baby have special needs with breastfeeding, lactation consultants (breastfeeding experts) can work with you. 

Mission’s Western North Carolina Breastfeeding Center rents and sells electric breastfeeding pumps for use after you go home. 

You can also call for an appointment with a lactation consultant if you have questions or problems after you go home. 

The number is 828-213-1103. 

38

For the safety of your baby 

We want you and your family to feel safe and comfortable. To provide you and your baby with the safest surroundings it is very 

important to: 

• Never leave your baby alone, even to take a shower. Staff can help care for your baby at any time. 

• Know your nurses’ names. 

• If someone you don’t know asks to take your baby, press the call bell for the nurse right away. 

• Put your baby in a bassinet any time he or she leaves the room. No one should carry your baby in their arms out of 

your room. 

• An electronic security system is in place on the Mother Baby Unit. Your nurse will explain how the system works. 

Your comfort 

Getting relief from pain is important for healing. Ask your nurse about pain medicine and other care that may be done to help 

you feel better. The pain medicines will not cause addiction and will help you get out of bed sooner. Being active will help you 

feel better. Tune in to our Relaxation Station, channel 32, for soothing music and photos. 

Spiritual support 

This can be a very emotional time and you may have special needs. Mission has chaplains in the hospital to offer spiritual 

support or a listening ear. At your request your nurse will call a chaplain. 

Learning more about baby care 

Channel 06 is the hospital’s newborn TV channel. Take time to watch these programs with your family while you are in the 

hospital, for information on caring for your new baby. 

Pictures 

Mission has a photo service to make some of your baby’s first pictures. You may want to bring a special outfit to the hospital for 

these. The nursing staff will give you more information about this service when you arrive. Right after the pictures are taken you 

will be able to select the ones you like and order from a range of package choices. With your permission, pictures will also be 

available for family and friends to see on Mission’s hospital website, www.missionhospitals.org. On the home page, look for 

“Interactive Tools” on the right side. Click on “Online Nursery.” 

Birth certificate and Social Security Card 

A Birth Certificate Clerk will visit you during your stay on Mother-Baby. She will collect information used to obtain a birth 

certificate and a social security number (or SSN) for your newborn. A SSN is required when claiming a new baby on an income 

tax return. The Social Security Administration will mail your baby’s social security card to the address of your choice. Mission’s 

Birth Certificate clerk will submit your forms and instruct you on the cost and steps for obtaining the official birth certificate 

from the Register of Deeds for Buncombe County. New parents are asked to come prepared with your choice for your baby’s 

name. Please take time to consider the choice and spelling of your baby’s name. It can be very time-consuming and require a 

lawyer to change names or information on this legal document. Many new families have questions about this legal document, 

like naming the baby, child support and paternity. It is always better to ask questions ahead of time. Feel free to call our Birth 

Certificate clerks at 828-213-8559 any time before your baby’s birth. 

39

G OING HOME 

How long will we stay 

The time you spend in the hospital will depend on the health of mother and baby. For a vaginal birth you may stay 1 or 2 days. 

After a cesarean birth you may stay 3 or 4 days. Our recommended check out time is 11 am to 12 noon. Please keep this in 

mind when making plans to go home. Please note, your doctor or midwife and your baby’s healthcare provider must complete 

their exams before you can be discharged. 

Before your baby goes home: 

• Hearing screening: Your baby’s hearing will be tested before going home. This painless test will measure how she or he 

reacts to soft sounds. This testing is done in your room and you will be told the results of 

the test after it is finished. 

• Newborn screening: State law requires all babies to be tested for certain diseases. Blood is taken from your baby’s heel for 

these tests. 

• Hepatitis B vaccine: Hepatitis B can cause liver problems and doctors now feel all newborn babies should be vaccinated to 

prevent this disease. Discuss this with your baby’s doctor prior to birth. 

• Circumcision: Circumcision means cutting away a small piece of skin covering the end of the penis. Please talk with your 

doctor or midwife about making this choice for your baby boy. It is also a good idea before the birth, to find out if your 

insurance plan covers the cost of circumcision. 

• A newborn exam: Your baby will be given a head-to-toe check-up in the first 24 hours after birth and on the day you go 

home. These records will be mailed by Mission to the doctor you have chosen to care for your baby. 

• Discharge Planner Consult: You may have a visit from the Patient and Family Services staff. They can talk with you and 

your health care provider about things you may need help with once you go home. They will then contact local programs 

that may be able to help you. 

Before Mom goes home: 

• The morning you go home you will have an exam by your doctor or midwife. 

• Take time to review how to take care of yourself and your baby with your nurse. 

• Some mothers may be given a Rhogam shot or Hepatitis B vaccine. Your doctor or midwife will talk with you about 

these medicines. 

• If you have questions or would like more help with breastfeeding your nurse can call one of the lactation consultants. 

• If you or your baby has special needs, your care provider may arrange for home visits by a registered nurse. Home visiting 

nurses can check for health problems, observe your progress and give you support. 

40

Car Seats 

Your baby must have a car seat the day he or she goes home. Car crashes are one of the leading causes of death for children under the 

age of 14. State law requires using a car seat and this is one of the best things you can do to protect your baby. Be sure you get one that 

is good quality and have it fitted for your car before you come to the hospital. Most infant safety seats are not put in cars the correct 

way. To make sure you know how to install your baby’s car seat correctly, call your local Fire Department, Safe Kids WNC 

(828-213-5548), or your county Health Center for help. Before you come to the hospital, it is a good idea to adjust the straps of the seat 

using a life size baby doll to get a fit that will be close to your baby’s size. 

Is your child safe in the car 

Most parents are surprised to find that their children are not safely secured in the car. Have a Child Passenger Safety Technician 

check your child safety seat. Nationally Certified Technicians are available at the following locations in western North Carolina. 

Call ahead to make an appointment with a trained professional. 

Buncombe County: 

• Safe Kids WNC/Mission Children’s Hospital 213-5548 

• Buncombe County Health Center 

Beverly Levinson 250-5156 

Susan Bolick (speaks Spanish) 250-5059 

• Asheville Fire Department 259-5640 

• Barnardsville Fire Department 626-2222 

• Enka-Candler Fire Department 667-0798 

• Fairview Fire Department 628-2001 

• Reynolds Fire Department 298-5200 

• Riceville Fire Department 298-2456 

• Skyland Fire Department 684-6421 

• Weaverville Fire & Police Departments 645-3500 

• Leicester Fire Department 683-3433 

• Upper Hominy Fire Department 667-1324 

Other Counties: 

• Henderson County SAFE KIDS 692-2581 

Valley Hill Fire Department 

• Jackson County Health Department 586-8994 

• Madison County Health Department 649-3531 

• Yancey County Health Department (Gail Crisp) 682-6118 

Sponsored by Safe Kids WNC/Mission Children’s Hospital 

41

We 

Did It

New 

Baby 

PARENTING GUIDE 

After the Birth and 

First 6 Weeks 


We Did It 

H OW D O I TAKE C ARE OF 

M Y B ABY 

Below are the basic instructions of how 

to take care of your new baby. Your 

baby’s doctor may also give you special 

instructions before you go home from 

the hospital. 

Baby care 

• Use a bulb syringe to remove mucous 

from baby’s nose and mouth. Squeeze 

the bulb before placing in nose or 

mouth. Release the squeeze in nose 

or mouth to remove mucous. 

• Rinse bulb syringe after each use. Use 

soapy water then clean water. Squeeze 

soapy water in and out of bulb. Then 

repeat with clean water. 

• Check the digital temperature under 

baby’s arm: remove shirt, place the 

thermometer under the baby’s arm, 

and press the button. Hold the 

thermometer in place until it beeps. 

Mercury glass thermometers are not 

to be used. 

• Normal temperature: 36.5 - 37.2 C 

or 97.6 – 99 F. A fever is greater than 

38 C or 100.4 F. 

• Do not use Q-tips to clean ears. 

Diapering 

• Change diapers when wet or soiled. 

• Use a mild soap and water with bowel 

movements to clean baby’s bottom. 

• Avoid diaper wipes at first. They can 

be irritating to the skin. 

• Girls may have mucous or blood-tinged 

discharge from the vagina during the 

first week, this is normal. 

• Always wipe bottom from front 

to back. 

Cord care 

• Apply rubbing alcohol to the cord, 

while gently pulling up on the end of 

the cord. Do this with each diaper 

change until the cord falls off. 

• Keep diapers folded below the cord 

to allow the cord to dry out. 

• Signs of infection include redness of 

skin around the cord and bad odor 

or drainage. 

Positioning 

• Lie baby on his back for sleeping. 

Now that he is sleeping on his back, 

you need to put him on his tummy 

each day. Spending time on his tummy 

helps him develop control of his head 

and back. This will help him later 

with crawling and walking. Be sure 

you can see your baby while he is on 

his tummy. 

Immunizations 

• Immunizations are very important to 

your baby’s health. Keep immunizations 

up to date. 

Breastfeeding 

• Your baby should breastfeed with 

feeding cues for at least 8 times in 

24 hours or every 2-3 hours. 

• Your baby is getting enough 

breastmilk if: 

By the time your baby is 5 days old: 

1. Your breasts feel heavier and firmer 

before breastfeeding, and, after 

breastfeeding, at least one of your 

breasts is soft. 

2. The baby softens at least one of 

your breasts every 2-3 hours or at 

43 

least 8 times in ever 24-hour 

period. 

3. You observe a rhythmic sucking 

and hear swallows for at least 10-20 

minutes at each feeding. 

4. After breastfeeding, the baby does 

not root (open his mouth when his 

lips are touched). 

5. The baby is soaking at least 6 

diapers in every 24-hour period. 

6. The baby has 3 or more mustardcolored, 

loose, seedy stools (not 

just smears) in every 24-hour 

period. 

• If you have sore nipples, questions or 

concerns, call the WNC 

Breastfeeding Center at 213-1103 or 

WIC at 250-5170. 

Lotions, soaps, oils 

• Baby skin is very sensitive to 

lotions, soaps and oils. 

• Use soaps and 

lotions recommended 

by your baby’s doctor. 

• Do not use baby 

powder. It can make 

your baby cough 

or sneeze. 

Safety at home 

• Never leave baby alone on a bed or 

changing table. 

• Never leave baby alone in a bath tub. 

• Always check water temperature 

before bathing. 

• Never hold the infant under a faucet 

of running water.

• Never shake your baby. It could 

hurt your baby very badly. 

• Learn CPR. Take our Safe Babies class. 

• Always use rear-facing infant car seats 

in the back seat of your car. This is a 

law in NC and all states. See page 41 

for local fire departments to schedule 

an appointment for installation. 

WARNING S IGNS IN 

A N EWBORN 

• Call your baby’s care provider if 

any of these signs happen in the 

first month: 

1. Axillary (under the arm) 

temperature above 99.5 F or 

below 97.7 F. 

2. Rectal (in the rectum) temperature 

above 100.4 F or below 97.4 F. 

• Refuses to eat for 8 to 10 hours. 

• Repeated vomiting that is forceful. 

• Yellow color of your baby’s face, chest, 

or the white part of the eyes (this 

may be newborn jaundice). 

• Changes in the way he acts: 

1. Sleeps past feeding time. You have 

trouble waking her up and she is 

limp in your arms. Newborn babies 

should have their arms and legs 

curled to their body when they 

are awake. 

2.Very fussy, crying without stopping, 

his cry is a very sharp squeaking 

sound. 

• Problems with the umbilical cord: 

1. Bright red blood the size of a quarter 

on her diaper or clothes. 

2. Red skin around the cord. 

3. Yellow-green discharge that 

smells bad. 

• Problems with the circumcision 

1. Bright red bleeding larger than 

a quarter. 

2. Swelling of the end of the penis. 

3. Yellow-green discharge that 

smells bad. 

• Less than 6 wet diapers in a 24 hour 

period after 4-5 days of life. 

• Problems with bowel movements: 

1. Hard, dry small round balls of stool, 

dark brown or black in color. It is 

hard for the baby to pass the stool. 

2. Bad smelling stool that may have 

mucous or blood in it. Most of the 

stool will be like water. 

• Problems with breathing: 

1. Blue color around lips. 

2. Deep pulling (sinking skin) 

between ribs. His breathing sounds 

like he is struggling. 

3. Her nose flares (opens wide) when 

she breathes. 

S PITTING U P 

Lots of babies spit up during the feeding 

or after they are done. Most of the 

spitting comes from: 

• Crying hard before the feeding. 

• Eating too fast. 

• Swallowing air while feeding. 

Milk can come up with an air bubble 

when he burps through his mouth or 

out his nose. Help your baby by feeding 

her before she is crying. 

A newborn’s stomach is the size of a 

large marble at birth and only the size 

of a golf ball by 3-4 weeks of age. 

• Handle your baby gently after feeding. 

Call your care provider if: 

• Your baby seems to be in pain with 

spitting up (crying loudly). 

• Large amounts of milk shoot out 

of your baby’s mouth for 2 or more 

feedings and your baby seems sick. 

44 

C OLIC 

Colic is: 

• Crying that does not stop after 

2-3 hours. 

• Crying day or night. The crying 

usually worsens at night. 

• Crying for more than 6 hours a day. 

Babies with colic will: 

• Scream when they cry. 

• Stiffen their legs out or draw their 

legs close to their tummies. 

• Pass a lot of gas. You may be able to 

feel the gas moving in his tummy. 

• Have a fat, tight tummy. 

One in 5 babies might get colic between 

2 and 4 weeks of age, but it usually 

stops by 3 to 4 months. Doctors are not 

sure what causes colic. Always talk to 

your baby’s care provider if you think 

your baby might have colic. 

Some things to try for a “colicky” baby: 

• All of the things in the “crying” 

section of this guide. 

• Stroke your baby’s tummy starting 

under the breastbone, back and 

forth, from one side to the other all 

the way down the tummy. Use firm 

but gentle touch. 

• Lay your baby tummy down across 

your legs and gently rub the back. 

Putting gentle, firm, warm pressure 

against the tummy may help. 

• Talk with your doctor if you think 

there might be a problem with your 

formula or breast milk. Some babies 

need formula that does not have 

cow’s milk in it. Some breastfeeding 

mothers might need to stop eating 

certain foods.

• When you feel tense and angry, put 

your baby in a safe place and leave the 

room. Call a friend or family member 

to come and help. Try to get away for 

an hour or two. DO NOT SHAKE 

YOUR BABY. Shaking a baby can cause 

blindness, brain damage, or death. 

M Y B ABY W ON’ T 

S TOP C RYING! 

It is normal for babies to have fussy crying 

periods each day. Most of the time the 

fussing is about 3-5 hours each day, by 

4-5 months it is about 1 to 2 hours each 

day. If your baby calms in a few hours 

and sleeps peacefully there is no reason 

to worry. 

For more understanding about why 

babies cry, view the DVD Period of 

Purple Crying. You will get a copy of this 

in the hospital. 

However, crying can be very hard to 

listen to without getting angry or tense. 

You may want to give the following a 

try: (From the book The Happiest Baby on 

the Block by Dr. Harvey Karp) 

1. Swaddle: Wrap your baby tightly in a 

receiving blanket. Wrap his arms and 

legs close to his body and hold him 

close to your body. 

2. Side Lying/Stomach: Holding your baby 

in your arms, place her on her tummy 

or side. 

3. Shimmy/Sway: Sway from side to side 

and gently bounce up and down (like 

Jello bouncing on a plate). 

4. Shooshing: make a loud continuous 

“Shhhh” sound. 

5. Sucking: Give him a pacifier to suck. 

His hands or fingers are O.K. too. 

Remember: NEVER SHAKE YOUR 

BABY. You could cause blindness, 

brain damage or death. 

H OW W ILL M Y B ABY 

A CT W HEN IT IS B ORN 

This is a good question! The more you 

know about your baby, the better you can 

love and care for him. You will also help 

his brain to grow better by stimulating 

his senses. Here are some things to know: 

Vision 

• At birth your baby can see 8 to 15 inches 

from her face. For 2 weeks her eyes 

are sensitive to bright light. By three 

months she will be able to see 3 feet 

away. Your baby sees the world in “black 

and white.” She does not see much 

color until about 4 months. Sometimes 

one or both eyes will cross until the 

muscles get stronger. The things your 

baby likes to look at the most: 

1. Your face, especially your eyes. 

2. Round shapes. 

3. Black and white things: a paper 

plate with black and white stripes, 

checker-boards or circles. 

4. Himself in a mirror. 

What can I do 

When your baby is quiet and looking 

around, take a bright colored toy (a panda 

bear is great) and let her look at it. Hold it 

in front until she sees it. Then move it a 

little to the right and a little to the left. 

Watch her eyes follow the toy. 

Hearing 

• Your baby hears from the moment he 

is born. He knows the voices of his 

mother, father, or people who have 

been around mom during the 

pregnancy. He likes the voices that 

are high-pitched like a woman’s voice. 

He also knows the heart beat sound 

of your womb. When he hears these 

familiar sounds he might stop crying 

or turn to listen to the sound. Some 

babies are upset by loud noise. They 

may cry or startle (throw their arms 

and legs out and shake) when they 

hear loud noises. 

45 

What can I do 

1. Talk to your baby all the time. 

2. Read books to your baby every day. 

3. Let your baby listen to calm music 

when she is awake or falling asleep. 

Smell and taste 

• Your baby’s sense of smell and taste 

are strong. Your baby will turn his 

head toward the smell of your breast 

milk but not toward another mother’s 

milk. Your baby will make a funny 

face and turn away from the smell of 

vinegar or alcohol. This sense of smell 

helps your baby at feeding times and 

warns him away from things that 

could harm him. He will like the taste 

of sweet things the most. 

What can I do 

1. Lay your baby on your chest next to 

your skin. She will learn who you are 

by the way you smell. 

2. Have her close by when you cook. 

Let her enjoy the smells. 

Touch 

• One of the best ways to show your 

love to your baby is with touch. He 

is very aware of things against his 

skin. The touch of another person’s 

skin against him is very calming. Soft 

things like cotton or sheepskin can 

comfort him. Scratchy things like 

plastic or wool will make him pull 

away. Your baby’s sense of touch is 

very strong. 

What can I do 

1. Cuddle, rock, and carry your baby 

close to you. 

2. Have soft things next to her skin. 

3. Massage your baby’s body with oils or 

lotions from head to toe. For more 

information about massaging your 

baby, see Support for New Mothers/ 

Families section in this guide. 

Note: Babies who get massaged grow 

faster, sleep better and have fewer 

problems with gas.

T HINGS M OMS N EED 

TO K NOW 

Warning signs after you have 

had your baby (call your Doctor 

or Midwife if): 

• Temperature 101° F or more by mouth 

• Burning or pain when you urinate 

• You can’t pass your urine 

• Swollen, red, painful area on the leg 

(especially the calf) 

• Passing a blood clot larger than a 

lemon and soaking a pad in the next 

30 minutes to 1 hour 

• Heavy bleeding that soaks a pad in 

1 hour or less 

• Itching, burning, or pain in vaginal 

area or strong odor to the discharge 

• Severe headache that gets worse when 

you sit up; the headache will hurt less 

when you lie flat 

• Yellow-green drainage from your 

cesarean incision 

• Severe pain when you push on 

your belly 

• Feelings of sadness or wanting to hurt 

yourself or your baby 

• Racing heartbeat, difficulty catching 

your breath, uncontrollable crying 

• Unable to sleep even when you are 

exhausted 

• Not wanting to get out of bed or care 

for yourself or your baby 

• Red areas or red streaks on your breasts 

• Rashes on your breasts or sore nipples 

Always call your doctor or midwife if 

you have any of these signs or if you are 

not sure you are having a problem. 

T AKING C ARE OF 

Y OURSELF 

Below are the basic instructions of how 

to take care of yourself after the birth. 

Your care provider may also give you 

special instructions before you go home. 

Activity 

• Avoid becoming too tired. 

• Rest as much as possible. 

• Following a cesarean birth, do not lift 

anything heavier than your baby for the 

first week, or drive a car for two weeks. 

• Gradually begin your usual activity as 

you feel up to it. 

Bathing 

• You may take a shower or tub bath. 

• If you have an incision, pat it dry 

with a towel. 

• Remove Steri-strips covering the 

incision only as they come loose. 

• Do not douche. 

• Do not use tampons. 

• Do Kegel exercises to help your bottom 

heal and to help with hemorrhoids. 

Sexual activity 

• Wait until your bleeding has stopped 

before having intercourse. 

• You may need to use a lubricant (like 

Astroglide) for intercourse. 

• Discuss with your doctor or midwife 

the type of birth control that is right 

for you. You can become pregnant 

even if you do not have a period. 

Bleeding 

• Use Peri bottle (you will get one in 

the hospital) and warm water to clean 

your bottom each time you use the 

bathroom. Pat your bottom dry while 

it is healing. 

• The bleeding will gradually decrease 

over a few weeks, becoming dark 

red/brown then yellow. 

• Your first period will start 4-8 weeks 

after birth if you are not breastfeeding 

and later if breastfeeding. 

• Your first period may be heavier 

than normal. 

Pain 

• Sitz baths or warm baths may relieve 

pain from your episiotomy. 

• Acetaminophen (Tylenol) regular or 

extra strength, 1-2 tablets by mouth 

every 4-6 hours for pain. 

• Ibuprofen (Advil, Motrin) 1-2 tablets 

by mouth, every 6-8 hours for pain. 

Exercise 

• Walking is good exercise. Begin as 

soon as you feel up to it. 

• Follow your doctor’s or midwife’s 

instructions about exercising 

after childbirth. 

Care when breastfeeding 

• Drink extra water and juices to replace 

fluid used to make milk while nursing. 

• Breastfeed your baby often. 

• Wear a supportive bra. 

• If nipples become sore, expose them 

to air. 

• Call the WNC Breastfeeding Center 

for questions at 213-1103 or WIC at 

250-5170. 

46

Care when not breastfeeding 

• Wear a tight bra. 

• Use ice packs if your breasts become 

swollen, hard, and tender. 

• Pain medication already prescribed 

may help. 

• Do not pump milk from your 

breasts. 

Diet 

• Eat a healthy diet as you did while 

pregnant. 

• Drink 8 glasses of water a day. 

• Remember, you gained weight over a 

period of time so plan to lose the 

extra weight slowly. 

• Avoid foods high in calories, with little 

nutritional value (like junk food). 

• Continue to take a daily multi-vitamin. 

Birth control 

• Follow your doctor’s or midwife’s 

instructions 

• If you take Depo-Provera (the shot), 

your next shot is due in 3 months. 

• You can ask your care provider about 

other birth control choices at your 

6 weeks check-up. 

• Breastfeeding is not a form of 

birth control. 

You can get pregnant even if you don’t 

have a period. 

Once you are home, call to schedule a 

check-up with your care provider. You 

may be given special instructions about 

this check-up before you go home from 

the hospital. 


Vaginal childbirth is a risk factor for problems such as urinary urgency and 

incontinence. Common symptoms are: 

• Having trouble making it to the toilet in time 

• Passing urine when you cough, sneeze, laugh or exercise 

• Making frequent trips to the bathroom 

If you experience any of these issues after your 6-week postpartum check-up, talk 

with your care provider. He or she may want to refer you to Mission’s Pelvic Floor 

Program. Visit missionhospitals.org/pelvicfloor for more information and to 

take an online self-assessment. 

47

D O I HAVE P OSTPARTUM 

D EPRESSION 

What are the baby blues 

• Over 50% of women who give birth 

go through strong emotional feelings, 

called baby blues. 

• This usually occurs within the first 

three days of birth and lasts about 

two weeks. 

If you have baby blues, you may feel: 

• Irritable • Nervous 

• Emotional • Overwhelmed 

• Bothered by mood swings 

• Tearful 

What can I do to try to cope with 

the baby blues 

• Sleep when your baby sleeps. 

(Exhaustion/sleep deprivation makes 

the blues worse.) 

• Get some exercise each day. 

• Have a support system you can call 

on (help with meals, chores, running 

errands, etc.). 

• Try to meet other mothers. 

• Take some time to relax each day. 

What is postpartum depression or 

anxiety 

• 1 our of 5 mothers have postpartum 

depression or other mood disorders. 

• Postpartum depression usually starts 

within the first six months after the 

baby is born, but can occur up to one 

year after the birth. 

If you have postpartum depression or anxiety, 

you may feel: 

• Extreme sadness 

• Afraid to be alone with your baby 

• Loss of interest in normal activities 

• No interest in your baby 

• Unable to cope 

• Fear of losing control 

• Not wanting to get out of bed 

• Extreme tiredness, fatigue 

• Extreme feelings of guilt 

• Thoughts of death/suicide 

• Not wanting to be with family/friends 

• Intense anxiety, fear, worry 

• Can’t sleep 

• Fast heart, dizziness for no reason 

• Thoughts of hurting yourself or 

your baby 

• Strange thoughts over and over 

• Feeling like a bad mother 

If you have some of these feelings, do 

not be afraid to get help. It does not 

mean you are a bad mother or that you 

do not want your baby. It means you 

have an illness that can be treated. The 

sooner it is diagnosed, the easier it is to 

treat and the sooner you will get better. 

Postpartum depression or anxiety can 

be treated with medication (even if you 

plan to breastfeed) and counseling. 

If you think you may have depression 

or anxiety, call your care provider as 

soon as possible. 

A support group is another helpful way 

to recover and heal. Call 213-8241 for 

information on the “This is Not What 

I Expected” group here in Asheville. 

What is postpartum psychosis 

• Postpartum psychosis is very rare. 

• It usually comes on very suddenly in 

the first month after birth. 

• This illness is very serious. You 

will need to go into the hospital 

immediately. 

If you have postpartum psychosis, you may 

experience: 

• Extreme confusion 

• Hearing voices telling you to hurt 

yourself or your baby 

• Very irrational thinking 

• Seeing things that are not there 

(hallucinations) 

• Severe agitation 

• Confusion about what is real and 

not real 

If you experience these symptoms, 

call 911 or have someone drive you 

to the hospital immediately. 

S UPPORT FOR N EW 

M OTHERS AND FAMILIES 

There are several places for new mothers 

to get help and support after their 

babies are born. 

48 

Breastfeeding support 

WNC Breastfeeding Center 213-1103 

Buncombe County Health Center 

WIC Lactation Program 250-5170 

Le Leche League 

Breastfeeding support group. 628-4438 

Parenting support 

Gentle Touch Parenting Classes & 

Infant Massage 

828-255-5648 

emma@GentleTouchParent-Child.com 

Moms Postpartum Support Group 

628-4438 or 213-9227 

Asheville Area 

Mothers of Multiples Support 

682-6223 

Mission’s Mommy and Me 

New mom education/support and 

mom/baby yoga. Woodfin YMCA or 

Reuter Family YMCA. 213-2222 

Mission’s Toddler Fun 

Structured play and support for moms. 

Reuter Family YMCA or 

Woodfin YMCA. 213-2222 

A Love Not Forgotten 

Pregnancy/newborn loss support. 

213-0263 or 213-8246 

MOPS (Mothers of Preschoolers) 

Support for moms with children up to 

school age. Child care provided. Log on 

for local meetings: www.mops.com 

Postpartum Doula Care 

233-5500 or 258-3327 

Helpmate: Domestic Violence 

254-0516 

Family Support Network 

Children with special needs. 213-0033 

This is Not What I Expected 

Support for women with pregnancy/ 

postpartum depression/anxiety. 

Call 213-8241 to register or 213-8246 for 

directions to meetings. 

Childcare 

Mountain Childcare Connections 

Finding a childcare program. 252-5955 or 

toll-free 1-877-752-5955

E ARLY B REASTFEEDING 

HOW TO GET BREASTFEEDING OFF TO A GOOD START: 

In Labor & Delivery and the hospital 

• Breastfeed as soon as possible after the birth. Most babies are alert and ready to try 

nursing. Early breastfeeding can help your milk supply and prevent problems later. 

• Try this first: Feed with as few people in the room as you can. With privacy you 

can be more relaxed and calm. 

• Get into a comfortable position. Support your back and use pillows to support 

your arms. 

• Try to nurse your baby anytime they are awake in the first few days. This is practice 

time for you and the baby. 

• Offer both breasts. 

• Don’t watch the clock, watch your baby. 

• Ask for help. 

• Remember some babies take a while to learn how to feed. Be patient. 

• Feed your baby when she opens her mouth if anything touches her cheeks or if she 

is trying to suck on her hands or fingers. 

After you are home 

Watch for the signs that your baby is getting enough milk: 

• Eats 8 to 12 times in 24 hours. 

• Has 6 to 8 soaking wet diapers in 24 hours. 

• Has 3 or more loose stools in 24 hours (some babies have stools at each feeding). 

• Seems happy after eating. Goes to sleep or is quiet while awake. 

• Is growing in length and gaining weight at check-ups. 

• You observe rythmic sucking and hear swallowing for at least 10-20 minutes 

each feeding 

Signs your baby may not be getting enough: 

• Eats fewer than 8 times in 24 hours. 

• Has fewer than 6 soaking wet diapers or the urine is a dark orange color. 

• Has fewer than 3 stools a day after day 2 of life. 

• Always seems hungry and fusses after feedings. 

• Mouth is dry. 

You can call a lactation consultant at the WNC Breastfeeding Center (213-1103) or 

the Buncombe County Health Center (250-5170) for questions or concerns. 

B IRTH S URVEY 

Share your birth experience on the following consumer feedback website: 

www.TheBirthSurvey.com 

Families choosing where and with whom to give birth can use this feedback to 

help with informed healthcare choices. 

49

M Y B ABY’ S F IRST 

C HECK-UP 

Here are some things you might expect 

at the first check-up: 

• Weighing a measuring the length of 

your baby, measuring the size of your 

baby’s head. (Newborns will usually 

gain 1 /2 an ounce to 1 ounce each day. 

Because they loose some weight in 

the first days after the birth, they will 

gain back to their birth weight after 2 

weeks of age.) 

• Your care provider will talk over how 

feedings are going. Here are some 

questions they may ask. 

– How often does your baby eat 

– How many wet diapers a day 

– How many stools (poopy diapers) 

a day 

– Does your baby sleep after 

feedings or do they seem calm 

after they eat 

– Is your baby spitting up with 

feedings 

– How much do they spit up 

How often 

Your care provider may ask questions 

about how your baby did during the 

labor, birth and first few days. 

(Remember: the hospital will send your 

baby’s records to your care provider. 

These records include the delivery 

information and the check-ups your 

baby had in the hospital.) 

• They may ask you about some health 

problems that run in the family. 

• It is important for your care provider 

to know how you and the rest of your 

family are doing with a new baby in 

the house. If you are having some 

problems, sometimes your care 

provider can give ideas that may help 

things go more smoothly. 

• Your baby will be checked from head 

to toes by the care provider (eyes, ears, 

mouth, tummy, heart, etc.). 

• Whether this is your first baby or 

tenth baby, there is always a chance 

to learn something new. Each 

baby is special and different. Ask 

questions, and talk about what you 

see or hear when you are caring for 

your baby. 

Learning is how you become the best 

parent you can be! 

Your baby’s brain and nervous system are still growing when they are born. This fast 

growth will last until about kindergarten, then it slows down. The nurses and your 

baby’s doctor will check your baby’s brain and nervous system in the hospital. You can 

keep watching for brain growth in the first months by watching for the following: 

Things your baby will do 

Age 

Look or stare at your face . . . . . . . . . . . . . . . . . . . . . . . . . . . Birth to 4 weeks 

Hold head off the bed for a few moments 

while lying on stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Birth to 4 weeks 

Pay attention to sound by becoming alert or 

turning toward it . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Birth to 6 weeks 

Smile or coo when you smile, talk, or 

play with her/him . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 weeks to 2 months 

Hold head upright while lying on stomach . . . . . . . . . . . . 5 weeks to 3 months 

Hold head steady when upright . . . . . . . . . . . . . . . . . . . . . . 6 weeks to 4 months 

Bring hands together in front . . . . . . . . . . . . . . . . . . . . . . . 6 weeks to 3 1 /2 months 

Laugh and squeal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 weeks to 4 1 /2 months 

Roll over from front to back or back to front . . . . . . . . . 2 months to 5 months 

Grasp a rattle placed in front of her/him . . . . . . . . . . . . . . 2 1 /2 months to 4 1 /2 months 

Your baby’s doctor will be watching for 

your baby’s growth too. In the first 2 years 

of your baby’s life the doctor will want 

you to come in for regular check-ups. 

Usually the schedule for “well child” 

check-ups is: 

• 1 to 2 weeks after the birth 

• During the first year at 2 months, 

4 months, 6 months, 9 months and 

12 months 

• From 1 to 2 years at 15 months, 

18 months and 2 years 

Talk with your baby’s doctor about 

immunizations. It is recommended 

that all newborns get a vaccination 

for Hepatitis B in the hospital. If you 

have questions or concerns please 

talk with you baby’s care provider 

before the birth. 

50


Radon is a colorless, odorless, radioactive gas that is the leading cause of lung cancer in non-smokers. Radon naturally 

comes out of the soil and rock and enters the environment. 

When radon gas is under a house, it can enter the house through cracks and openings in the foundation and collect in the 

air of the home. The levels of the gas in the air can become unsafe. 

Testing a home for radon is simple and easy. The NC Radon Program provides radon test kits free of charge for 

expecting families. Simply call 828-301-8807 for more information. 

For a home that has unsafe levels of radon (above 4pCi/L), there are several ways to remove the gas. The process is called 

mitigation. The best way is to hire a certified radon mitigator. They are trained in the proper ways to remove the gas. 

Visit www.ncradon.org for a list of certified mitigators in the state. 

Learn more about newborns and toddlers up to age 3 from our weekly e-newsletter. Visit theparentreview.com/missionhealth 

to sign up. Encourage friends and family to sign up as well. 

N OTES

M ISSION 

H OSPITAL IS THE F IRST B ABY-FRIENDLY H OSPITAL IN NC! 

What does this mean 

The Baby Friendly Hospital Initiative (BFHI) is a world-wide program sponsored by: 

• WHO (World Health Organization) 

• UNICEF (United Nation’s Children’s Fund) 

BFHI promotes, protects and supports all efforts for initiating and continuing breastfeeding. 

It encourages and recognizes hospitals and birthing centers that offer the best care for breastfeeding. 

BFHI assists hospitals in giving breastfeeding mothers: 

• Information 

• Confidence 

• Skills needed to be successful! 

For more information, visit www.babyfriendlyusa.org. 

509 Biltmore Avenue,Asheville, North Carolina 28801 

missionhospitals.org 

Written by Christi Lorenz, BSN, CCE 

The information contained in this publication should not be considered specific medical advice, as each individual’s circumstances differ. 

Should you feel a need for medical advice, do not rely on knowledge gained from these articles but seek advice from your physician. 

© Mission Hospital 2010

New Beginnings: Pregnancy Guides - Mission Health

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