Dr. Shanbour specializes obstetrical care, he knows there is nothing like welcoming a child into this world. He only wants only the best for you and your baby. We deliver the highest quality prenatal care and are on the forefront of providing great medical care. Dr. Shanbour is well supported by his compassionate staff members and together, we work as a team to encourage and assist you throughout this special experience.
When you arrive for your first appointment with Dr. Shanbour, he will collect a comprehensive medical history from you and in return give you a welcome packet which contains many useful and informational items. During this visit, necessary laboratory testing with be conducted such as an ultrasound and pelvic examination; a pap smear might be needed at this time. Also routine inspections of weight, blood pressure, urine, and fetal heart tones will be checked on this day and on all future visits.
Your prenatal visits will officially start on your next visit, four weeks after your first appointment. Dr. Shanbour will see you at every prenatal visit and he delivers all of his patients babies unless on vacation. He also provides you with his personal cell phone number, which you can call 24/7 for any questions or concerns. You will be seen every 4 weeks until your 28th week, at 18- 20 weeks you will have a 18 week ultrasound. At 28-36 weeks you will be seen every 2 weeks and at 36 weeks you will be seen weekly. However, please keep in mind certain circumstances might require the need to deviate from this schedule.
Family planning encompasses a host of services and even if we don't offer the service you may require, we're knowledgeable and happy to assist you in any way we can.
We offer oral contraceptive pills, patches, rings, IUD's (Mirena, Skyla, Liletta, and Paraguard), and injectable medications (Depo-Provera). For those patients who desire a more permanent solution and have completed their child-bearing, we offer the no-incision the NovaSure Ablation. Please note that no method of contraception is 100% effective. If you are considering contraception, please feel free to schedule an appointment to discuss which method may best suit your need.
We have access to a full complement of the most advanced testing and screening currently recommended for genetic screening prior to and during your pregnancy. Including Harmony and Counsyl. We utilize the services of several high-risk specialists when required and they are affiliated with The Perinatal Center of Oklahoma, Mercy, Baptist and CDI.
Harmony - The Harmony test is a type of non-invasive prenatal test (NIPT). The Harmony test assesses blood from the mother, looking at the baby's DNA in her blood (analyses maternal serum for fetal DNA). It provides limited screening for chromosomes 21, 13, 18 and/or XY (sex chromosomes). This can be done as early as ten weeks.
Consuyl - DNA screening for the important moments in life. We help you make smart choices about your health, your family, and your future.
A first trimester ultrasound may be performed to visualize your baby’s heart beat and to confirm your due date. We will also offer an ultrasound examination to be done when you are between 18 to 20 weeks. The purpose of the ultrasound is to screen for major birth defects, determine the position of the placenta and assess the growth of your baby.
HPV Vaccine: HPV (Human Papilloma Virus) is a sexually transmitted disease and the spread of some types of the virus are associated with cervical cancer. We offer the Gardisil vaccination to prevent infection with those types of the virus most associated with leading to cervical cancer.
CBC: Complete blood count identifies different types of anemia and platelet abnormalities.
Blood Type and Antibody Screen: looks for potential blood group (Rh) incompatibility between your blood and your baby's blood.
HIV: the human immunodeficiency virus (HIV) causes AIDS and testing is offered and strongly recommended. Identification of an HIV infection will aid the prevention of transmission to your newborn.
Rubella (German Measles): testing is performed to confirm immunity to German Measles (rubella). If you are non-immune, you should avoid exposure to infected individuals. A rubella vaccination should be obtained after delivery.
Varicella (Chicken Pox): testing is recommended if you are unsure whether or not you have had chicken pox. If you do not have immunity to varicella, you should avoid contact with infected individuals. It is recommended you receive a Varicella vaccination after delivery.
Syphilis: testing is important. Syphilis can cause severe birth defects if it is not detected during your pregnancy, therefore testing is mandatory.
Hepatitis B: the Hepatitis B virus can lead to liver disease and liver cancer. Special precautions are taken at the time of delivery to prevent transmission to your baby if you are found to be a carrier.
Hepatitis C: testing for the Hepatitis C virus will be performed for those patients interested in a water birth.
Gonorrhea and Chlamydia: DNA probes are used to screen for gonorrhea and Chlamydia infections of the cervix which can infect a newborn.
Urine Culture: tests for urinary tract infections, infections, which are more common in pregnancy, usually less symptomatic and can lead to kidney infections if left untreated.
Bacterial Vaginosis: This type of vaginal infection that may cause preterm delivery.
Group B Streptococcus Culture: is performed between 35 and 37 weeks. This form of infection is caused by a bacterium commonly found in the human gastrointestinal and genitourinary tracts which can infect a newborn during delivery. We follow the guidelines recommended by the American College of Obstetricians and Gynecologists to administer antibiotics during labor for all pregnancies at risk for an infection.
Cystic Fibrosis is a life-long illness that is usually diagnosed in the first few years of life. This disorder causes problems with breathing and digestion. Cystic Fibrosis does not affect intelligence. Cystic Fibrosis testing may not be covered by your insurance. The estimated carrier risk is as follows: Ashkenazi Jewish 1/25, Non-Hispanic Caucasian 1/25, African American 1/65 and Hispanic-American 1/46.
If your occupation or social circumstances predispose you to other infectious diseases such as Tuberculosis, Fifth Disease or Toxoplasmosis, additional testing may be appropriate.
There are many factors to think about in choosing birth control after delivery, including
Ultimately, you may not request any birth control at all. If there is additional information we can give you to help you in making this decision please do not hesitate to ask us.
Oral contraceptive pills - For most women who are accustomed to taking the pill and who have done well on the pill in the past, the simplest, cheapest and most flexible form of birth control after delivery may be resuming the birth control pill. Most pills contain a combination of estrogen and progesterone. While establishing breastfeeding we try to limit estrogen use as it may reduce your milk supply. Therefore, if you choose to be on the pill we typically would start you on a progesterone-only pill (sometimes referred to as the “mini-pill”) while you are establishing breastfeeding and then switch you back to a combination pill once breastfeeding is well- established or once you stop nursing. By itself the mini-pill may not provide as reliable birth control as the combination pill; breastfeeding plus the mini-pill is equally effective, but once you stop breastfeeding a combination pill is more reliable. If you choose to be on an estrogen containing product your health care provider will review in detail the potential side effects and may have you sign a consent form indicating you are aware of those side effects.
IUDs - For those women who are looking to minimize hormonal exposure, and who want easy to use and extremely reliable long-term birth control, an IUD can be a great option. This is a small plastic device that is inserted in the uterus in the office in a minor procedure that requires no anesthesia. There are 4 IUDs available –All are extremely reliable protection against pregnancy, as reliable as a permanent tubal ligation, but IUD contraception is entirely reversible. IUDs do not interfere with breastfeeding nor cause any problems for future pregnancies
Depo Provera - This is an injection given every 3 months of a type of progestin that provides highly reliable contraception. The most common side effects include unfavorable changes in bleeding patterns, mood changes and weight gain. It is safe to use while breastfeeding.
Nuvaring - This is a plastic ring which is inserted in the vagina that releases both estrogen and progesterone that works in a similar fashion to the combination pill, but is simpler to use as it does not require remembering to take a pill every day. Because it contains estrogen we may advise against the use of Nuvaring while breastfeeding.
Sterilization - For those who are absolutely certain that they are done having children sterilization may be desired. There are several different forms of sterilization including § male sterilization or vasectomy (your partner would need to discuss this with their family doctor or a urologist), and female sterilization commonly referred to as tubal ligation (having your tubes tied). Laparoscopic tubal ligation may be done as an outpatient surgery o typically 6 weeks or more after delivery. This has a slightly lower failure rate than the postpartum tubal ligation, but does require a general anesthetic.
For those patients desiring tubal sterilization who have Medicaid as their insurance provider you will need to sign a special form (Med 178) at least 30 days in advance of your procedure indicating: 1) that you understand this is a permanent procedure, 2) you know there are other forms of birth control that are reversible that are available, and 3) you would like to have this done.
