Frequently Asked Questions

What are Dr. La’s credentials?

Dr. La graduated summa cum laude from Baylor University and earned his M.D. from the University of Texas Southwestern Medical School in Dallas.  He completed his internship and residency at the Memorial-Hermann Hospital in Houston’s Texas Medical Center.  Dr. La is board certified by the American College of Obstetrics and Gynecology.  Yearly, he maintains his board certification after completing and passing an exam to show competency in the area of obstetrics and gynecology.  Dr. La has been in practice since 1999.

How many weeks/months am I?

Pregnancy is measured from the first day of your last period.   An ultrasound is performed to determine the date and is compared to the first day of your last period.  If the ultrasound shows a difference of less than 7 days, the last menstrual cycle date is used.  If the difference is greater than 7 days, then the ultrasound date is used.   During the first 13 weeks, you are considered in your first trimester, the second trimester is from 13-26 weeks and the third trimester is 26 weeks until delivery.

When should I tell people that I am pregnant?

Approximately 15% of diagnosed pregnancies end in miscarriage.  The most common reason for the miscarriage is a chromosomal abnormality from conception; therefore, never developing a normal embryo.  The risk of “spontaneous abortion”  (a/k/a “miscarriage”) is much lower once we see a heartbeat.  Babies, with a heartbeat after 8 weeks from the last period, have a less than 5% risk of miscarriage.  After 12 weeks, the risk is less than 1%.  Therefore, many patients choose to wait to tell others until they are past their 12th week of pregnancy.  However, this is a personal choice and depends on how you would feel if others knew you had had a spontaneous abortion should this should occur.

What/how much should I eat during pregnancy?

  • 300 extra calories a day is needed when pregnant
  • 25-35 pounds is the ideal amount to gain during pregnancy (0-5 pounds during weeks 1 – 12, 1 pound/week for the remainder of pregnancy)
  • Foods to Avoid:
    • Fish High in Mercury:  shark, swordfish, tilefish, king mackerel
    • Tuna steak – no more than 6 ounces a week
    • Unpasteurized cheese and deli meats
    • Raw fish (sushi) and raw meat (carry parasites that could harm mother and fetus)
    • All alcohol
    • Limit starches and sugars to avoid weight gain and/or gestational diabetes
    • Caffeine (no more than 1 caffeinated beverages daily)
  • Foods that can be eaten:
    • Fish low in mercury:  shellfish, shrimp, snapper, catfish, salmon, canned tuna – up to 12 ounces per week
    • Deli meat that has been heated in a microwave until steaming is safe to eat

Can I exercise?

If you have an uncomplicated pregnancy, you can continue your current exercise regimen with a few exceptions:

  • Cardiovascular (walking, running, stationary biking, elliptical trainer) – keep your heart rate at a maximum of 160 beats per minute.
  • If you work out with weights, modify exercises that require you to be flat on your back or stomach after 12 weeks.  Limit weights to a maximum of 25 pounds.
  • Discontinue abdominal exercises; they won’t be effective
  • For those who are not regular exercisers, walk for 20-30 minutes 3-5 days a week.  Consider a prenatal yoga or Pilate’s class.
  • Do not exercise if you have complications such as bleeding, preterm labor or high blood pressure or Dr. La has advised you against exercising.

What about sex?

Unless you have complications such as bleeding, preterm contractions or low-lying placenta, sex is safe in pregnancy.  Sex may cause mild contractions but it will not make an otherwise healthy pregnant woman go into premature labor.  Unless Dr. La tells you otherwise, you may continue your normal sexual practices if you want to.

Can I paint my baby’s room?

Yes, but make sure the room is well ventilated while you are painting.   Also, do not eat or drink in the room you are painting.

Can I take a bath?

Yes, but keep the water temperature between 98 – 101 degrees.  Do not expose yourself to very high temperatures (more than 103 degrees F) for long periods of time in baths, hot tubs or saunas.  Exposure to these temperatures can increase the risk of spina bifida during the first 2 months of pregnancy.

Can I travel?

  • Domestic travel: 
    • Travel up to 36 weeks unless you are having complications with your pregnancy
    • After 36 weeks, stay close to home
  • International travel:
    • Travel up to 25 weeks unless you are having complications with your pregnancy
    • After 26 weeks, international travel is not advised unless absolutely necessary
  • When flying, wear support hose and walk as much as possible (at least once every hour) to prevent blood clots.  Drink plenty of fluids.
  • On long road trips, make frequent rest stops to stretch your legs and maintain circulation.

What if I have a cat?

  • Outdoor Cats
    • Can be exposed to Toxoplasmosis and can pass this parasite to humans through their feces
    • A pregnant woman could acquire it by changing the litter box of an infected cat.
    • Someone else should change the litter box while you are pregnant
    • If you live alone, wear gloves – every time – and wash your hands afterward.
  • Indoor Cats
    • Cannot be exposed to Toxoplasmosis if they live inside and eat only processed cat food
  • Cuddling your cat is safe and will not expose you to the disease
  • Dogs are not affected by Toxoplasmosis

Which vitamins/supplements should I take?

  • Folic acid – (shown to reduce spina bifida)
    • Take 400 mcg the month prior to pregnancy and for the first 2 months after conception
    • You may require more folic acid if you have a family history or previous child affected with spinal bifida
  • Prenatal vitamins
    • General multivitamin with 400-100 micrograms of folic acid plus calcium and iron
    • Reduces anemia and makes up for any imperfections in diet
    • Between 1000-1200 mg of calcium is necessary daily from diet and/or supplementation.
      • Do not take calcium and iron (in the multivitamin) at the same time as they can offset each other’s absorption.
      • Calcium citrate is the best absorbed but fruit flavored “Tums” or chocolate flavored “Viactiv” may be more appealing.
    • DHA 200mg (from fish oil or flax seed oil) provides Omega-3 fatty acids (a/k/a Essential Fatty Acids (EFAs).
      • EFA deficiency may contribute to a number of pregnancy complications including preterm labor or pre-eclampsia.
      • EFAs may help fetal eye and brain development and are passed into the breast milk.
    • If you eat fish 3 times weekly, you are getting plenty of Omega-3 fatty acids and do not need to take the DHA.

What medications can I take?

Please refer to our medication list to review medications that can be taken during pregnancy.  If you need a medication that is not on the list, please call our office during business hours for advice.

Do I have to lie/sleep on my left side?

In the third trimester, blood flow can be decreased to the baby if you lie on your back.   This will also cause blood flow to your head to be decreased causing dizziness and lightheadedness.  Therefore, if you have a healthy heart, your baby will receive maximum blood flow if you tilt your abdomen slightly left or right.  Prior to the third trimester, you can lay comfortably on your back without significant blood flow problems.

Is ultrasound safe?

After years of study, obstetric ultrasounds have been found to be safe for the baby.  However, current recommendations are to limit the use of ultrasounds to what is medically useful or necessary.  Our current office policy is to provide three (3) ultrasounds.  These ultrasounds include the one that is done on your first visit to determine viability, then one is done at 20 weeks to review the baby’s anatomy and then the final ultrasound at 36 weeks to review growth and fetal well being.  In the event that you or your baby begin experiencing problems (example: gestational diabetes, low growth rate, etc), Dr. La may order additional ultrasounds.    If you will be 35 years or older at the time of your baby’s birth, Dr. La may order the 20 week ultrasound to be done elsewhere.  The sex of the baby can usually be determined at the 20 week ultrasound.

Some patients would like a picture of their baby.  This can be done by a “4D” ultrasound but since it is not medically necessary most insurance companies will not pay for the ultrasound.  There should be no harm to your baby if you decide the have the ultrasound done and our office will be happy to provide you with recommendations and orders on where to have the ultrasound done.

Can I go to the dentist?

Routine dental work is safe during pregnancy although your dentist may require a note from our office saying the visit is safe.  We encourage you to keep up with your normal dental routine.   If you require extensive dental work, our office will be happy to discuss the best options for medication with your dentist.

Where will I deliver?

Dr. La will deliver your baby at The Women’s Hospital of Texas at West Houston (TWHWH) (www.westhoustonmedical.com)  In late 2010, the hospital underwent a complete renovation and expansion of the Labor & Delivery, Post Partum and Nursery departments.  The large labor suites are state of the art and post partum rooms are all private rooms.  Additionally, there is space to accommodate overnight visitors.  Anesthesia is available 24 hours a day and neonatologists are on call 24 hours a day.

How do I register at the hospital and take a tour?

You should register with TWHWH Registration Department by the 26th week of your pregnancy.  This ensures that all of your information is in the hospital computer system in the event that you need to be hospitalized earlier than your due date.   The Registration Department is open Monday – Friday from 7:00 a.m. to 6:30 p.m. and Saturday from 7:00 am.

You may also register online by going to www.westhoustonmedical.com.  Go to “Search & Schedule”.  Go to “Essentials” (located at the bottom of the screen) and click “Pre-registration and Mammogram Scheduling”.  Click “Enter Secure Site”.  Type in the word shown on the screen and press “enter”.  Click “Next Step – Patient Information”.  Select “Labor & Delivery” from the drop down menu of “Reason for Visit”.  Complete your information and “submit”.

To schedule a tour or attend a Childbirth Preparation or Breast Feeding Class, please contact 281-588-3444 to schedule.  For a list of classes, dates and associated costs, you may go online to www.westhoustonmedical.com.  There is a cost for the Childbirth Preparation class but our office can provide you with a coupon that provides you with a 50% off rate.

When will I deliver?

Full term delivery is considered 40 weeks and most women deliver close to their due date (40 weeks from the last period).  However, there are some women who deliver before 37 weeks and some who deliver after 40 weeks – particularly women who are pregnant with their first child.  If you have had preterm labor, in the past, you are more like to have another preterm delivery.  Beginning at week 36, if not before, you will be seeing Dr. La on a weekly basis so that he can monitor your pregnancy.

If you will be delivering by C-section, you will probably be scheduled at about 39 weeks or if you are having twins, you may deliver around 37 weeks.

Who will deliver my baby?

Dr. La is on call Monday – Friday of every week.  On the weekends, he alternates call with other Board Certified Obstetricians.  If your baby should be born on a weekend when Dr. La is not on call, one of these physicians will deliver your baby.  This rarely (10%) happens but it could occur.   If you would like to ensure that Dr. La delivers you, ask him if elective induction is an option for you.  Elective Induction allows Dr. La to “schedule” the day your baby will be born though only if you are at least 39 weeks and have a favorable cervix.

How long will I stay in the hospital?

If you have a vaginal delivery, your hospital stay will be up to 48 hours.  If you have a C-section, your hospital stay will be up to 96 hours.  Unless there is a medical complication, your insurance company will not pay for a longer stay.  When it is time for you to leave the hospital, you will receive instructions on your care once you are at home.  You will need to call and schedule your next appointment (“post partum”) with Dr. La.  Dr. La wants to see you 4 weeks following a vaginal delivery or 2 weeks following a C-section.

Who will my baby’s doctor be?

You will need a pediatrician with privileges at Women’s Hospital – West Houston (TWHWH) (www.westhoustonmedical.com) to see your baby before discharge.  Our nurse will provide you with a list of pediatricians who have privileges at TWHWH at your OB appointment.  Some patients want to interview the doctor before delivery or you may feel comfortable meeting the doctor when he/she comes to see your baby at the hospital.  The baby usually has his/her first appointment with the pediatrician about 2 weeks following birth.  You will need to contact the pediatrician’s office to schedule a date and time.

Should I take a Childbirth Preparation and/or Breast Feeding Class?

Many women, especially first time mothers, want to take a childbirth preparation class.  Although the class is not required, it may help you become more comfortable about what to expect.  The class dates and times can be found at www.westhoustonmedical.com.  There is a cost for the Childbirth Preparation class but our office can provide you with a coupon that provides you with a 50% off rate.

Breast Feeding Classes are also available for women who are interested, or curious, about breast feeding.  The class dates, times, and associated costs can be located on the website at www.westhoustonmedical.com

Should I get an epidural?

Epidurals are a safe and effective way of controlling pain associated with childbirth.  For that reason, the majority of women do opt for an epidural.  Complications from epidurals are extremely rare and often easily corrected (example: severe headache).  Since anesthesiolo-gists are available 24 hours a day, you do not need to make any prior arrangements for an epidural.

Can I deliver vaginally after a C-section?

Vaginal delivery after a C-section is known as VBAC.  Dr. La does not offer VBACs .  There is a 1% risk that when a mother is in labor with a C-section scar on the uterus, the scar could open up and expel the baby and placenta into the mother’s abdomen.  When this happens, it is known as a “uterine rupture”.  A uterine rupture is a catastrophic emergency that could result in the death or permanent disability of the baby and severe blood loss and hysterectomy for the mother.  Dr. La believes that a 1% risk is too high when it comes to you or your baby’s safety.

Will I get induced?

There may be medical reasons that Dr. La would want to induce you.  Some of the reasons include:  high blood pressure, low amniotic fluid, poor fetal growth or being more than a week past your due date.  If any of these conditions should occur, Dr. La will discuss why he feels induction should occur.  At this point, he has determined that you and/or your baby’s health will be better with the baby on the outside rather than inside the mother.

There is also something known as an “elective induction”.  This means that although there is no medical necessity to deliver the baby at this time, it would be more convenient for family members, work schedules, etc.  Elective inductions are scheduled around the 39th week of pregnancy.

Will I have an episiotomy?

Dr. La tries to avoid episiotomies unless he decides that it is safer to make a small episiotomy rather than to risk a large tear.  However, this decision cannot be made until the baby’s head is partially delivered.  Dr. La cannot control variables such as the size of your baby’s head or your body’s ability to stretch which ultimately determines whether or not you can safely deliver without an episiotomy.  The more pregnancies you have, the less likely you will need an episiotomy.

Should I have my baby boy circumcised?

There is no medical reason for circumcision according to The American Academy of Pediatrics.  However, many people decide to have the circumcision done for religious, cultural or cosmetic reasons.  If you decide to have your baby circumcised, Dr. La will do the procedure – usually the day after birth.

Should I collect my baby’s cord blood?

Blood from your baby’s umbilical cord contains stem cells which may be collected and stored after the baby’s birth.   Stem cells have numerous current and possible future medical uses that warrant consideration.  There are no public banking systems, to store the cord blood, at this time.  However, there are several private companies that offer storage options.  If you are interested in cord blood collection, you may want to visit the websites for Cord Blood Registry (www.cordblood.com) or Viacord (www.viacord.com) to learn more.  Dr. La will also be happy to discuss this option with you.

How do I prepare for breastfeeding?

The Women’s Hospital – West Houston (TWHWH) offers a class in breastfeeding.  To locate the dates, times and associate costs, please visit www.westhoustonmedical.com for more information.  TWHWH also has a lactation consultant who can answer any questions you might have.  If you need help after you leave the hospital, please contact our office for assistance.

When should I contact Dr. La?  How do I contact Dr. La in an emergency?

Our office hours are 8:00-5:00 Monday – Thursday and 8:00 – noon on Fridays.  After hours, our phones are forwarded to an answering service who will take your name, phone number and nature of your problem.

Emergency Concerns:  For emergency concerns after hour, please contact our main number and the answering service will relay your message and the doctor on call will return your call.  Although the on call doctor is always available for emergencies, we ask that you use your judgment and not contact the doctor with matters that can be handled the next business day.

If you are pregnant and are in your 1st or 2nd trimester, and experience any of the following, you should contact our office or the on-call physician after hours:  vaginal bleeding that is more than spotting, severe pain, fever higher than 101.0F, persistent cramping or vomiting that is preventing fluid intake for more than 24 hours.

If you are pregnant and in your 3rd trimester, and experience any of the following, you should contact our office or the on-call physician after hours:  vaginal bleeding that is more than spotting, decreased or absent fetal movement (at rest, you should feel at least 6 small movements an hour), regular, painful contractions, leaking amniotic fluid (a persistent trickle or gush of watery fluid) or if your contractions have been 5 minutes apart or less for at least an hour.

If you are worried or are not sure if you are in labor, it is best to call.  If you feel that you need to go to the hospital, please contact Dr. La or the on call physician so he can let the hospital know that you are coming and why.  The front doors of the hospital close at 9:00 p.m.   After 9:00 p.m., you will need to go through the Emergency Room (located in the back of the hospital) to get to Labor and Delivery.

Non-Emergency Concerns: If you are an existing patient, please use your Patient Portal to communicate with Dr. La about any non-emergency problem you are experiencing.  You should expect a response no later than 24 hours – although it is usually does not take this much time.   Many times, Dr. La can advise you what to do and save you a trip (and copay) to the office.

Medications will not be refilled by the on call doctor so please have these requests dealt with during regular business hours.  Again, if you are an existing patient, use your Patient Portal to communicate with Dr. La if you require a prescription filled before the next business day.

How does my insurance work?

Each insurance company is different and our office strives to provide you with the best verification information that we can.  However, NO insurance company will guarantee benefits until the claim has been received in their office and processed.  Therefore, you are responsible for any charges not paid by your insurance company.

Most insurance plans will pay Dr. La for a global fee.  The global fee is a fee that is charged for all maternity-related office visits, delivery of the baby and post partum visits.  The global fee does not include ultrasounds or lab work; these will be billed separately.  Since the global fee includes the delivery of the baby, we cannot bill until your baby has been delivered.   If you are seen by Dr. La for something unrelated to pregnancy, our office will submit a claim to your insurance company and you may be asked to pay a copay for that visit.

Most policies have a deductible or co-insurance portion that you will be responsible.  You will be asked to pay Dr. La’s portion by the 24th week of the pregnancy.  After your OB visit with the nurse, you will meet with a financial counselor to discuss what you will owe Dr. La for his services and to answer any questions you might have.

During your hospitalization, there will be other companies who will be involved in you and your baby’s care.  Their fees are separate from Dr. La’s fees and should be paid, at least in part, by your insurance company.    To learn more about the services offered by these providers, please review “Patient Forms – Ancillary Services”.

Please remember that Dr. La is a medical expert – not an insurance expert.  Therefore, please direct your insurance and billing questions to our staff.  Or, contact the Member Services Phone Number located on your insurance card.

Can I bring someone to my appointment?

The majority of spouses and/or significant others will come on the initial visit to meet Dr. La and our staff and then at the 20 week ultrasound to learn the sex of the baby.  However, we welcome them to all visits if they wish to come.

We love children – especially well behaved ones – but our office is not equipped to baby sit your child.  Therefore, please bring a responsible person with you to care for your children while you are being examined.  And, please be considerate of other patients…if your child is crying or misbehaving; please take him/her to the hallway.  If you will let our receptionist know that you are going to the hall, she will call your cell phone to let you know when it is your time to be seen.  Please make sure we have the correct cell phone number.

What can I expect at my appointments?

After the initial visit(s) and ultrasound confirms your pregnancy and due date, a standard panel of blood tests will be done to check your blood type, blood count, immunity to Rubella, as well as tests for exposure to HIV, hepatitis and syphilis.  Your next appointment will be an OB appointment scheduled with our nurse.  This visit is done on Thursdays and the purpose of the visit is to obtain detailed and current medical history on you and the baby’s father as well as to review your lab results.  First trimester screening for Down’s syndrome and other chromosomal abnormalities will be offered.  Other necessary tests based on your individual health assessment will be done.  You will also meet with a financial counselor to discuss your financial responsibilities.  Due to the amount of information that we will be discussing, please do not bring a child to this appointment.

16-20 weeks from last period:  A detailed ultrasound will be performed at 20 weeks to review the anatomy of the baby.  Our ultrasound tech should also be able to inform you of the sex of the baby if you wish to know.  The ultrasound should be covered by your insurance company.  An alpha-fetoprotein (AFP) test for spina bifada will also be offered.  If you are having an amniocentesis it will be scheduled at about 16 weeks.

24-28 weeks:  Testing for gestational diabetes will be done.  You will be given a sweet drink “glucola” and your blood will be drawn an hour later to screen for diabetes.  If your first test is high, you will be asked to do a second test that takes 3 hours.  If your blood type is RH negative, you will receive a shot of Rhogam at about 28 weeks.  At this time, we will begin reminding you to register at the hospital, sign up for a childbirth class if desired, choose a pediatrician, and consider issues such as cord blood banking and circumcision.

36 – 40 weeks:  Testing for GBS (Group B Strep) will be done with a vaginal/anal swab.  GBS is a harmless bacterium that many people carry without symptoms but can rarely lead to a serious neonatal infection.   If you are a carrier, we will give you antibiotics when you are in labor to prevent neonatal infection.  Your cervix will be checked weekly for dilation and effacement and to make sure the baby’s head is down.

We know that your time is valuable and we do our best to see you timely.  However, if a patient is having a problem (example: hasn’t felt her baby move or a possible ectopic pregnancy) Dr. La may be delayed.  Please bring a book to your appointments as we cannot always predict when this might occur.  Our receptionist will do her best to keep you informed if there is a delay.    If you are unable to wait, she will be happy to reschedule you for another day and/or time.