Carlos and Parnell, M.D., P.A.
standard-title Obstetrics

Obstetrics

First of all, congratulations! Pregnancy is celebrated at Carlos & Parnell, and we are honored you have chosen our practice to help you with this miraculous experience. Please remember, our doctors and their medical assistants are always available for any questions or concerns you may have. We are with you every step of the way!

Our in-office protocols for prenatal care include providing you with information packets, so you will be prepared for each step along the way. At your first visit, you will have an ultrasound to confirm the viability of your pregnancy, and to give you an accurate due date. You will then receive an individualized care plan, indicating the timing of each of your upcoming prenatal visits, and detailing what will be done. Completing your first visit, you will have ample opportunity to ask your doctor any questions or voice any concerns you might have.

Smiling Doc and AssistantWe want you to leave feeling informed and excited about the fascinating journey to come. Starting with your first visit and continuing for each trimester of your pregnancy, you will have an ultrasound to monitor the development and growth of the baby. An optional nuchal translucency ultrasound at 12 weeks provides a non-invasive diagnostic test to rule out Down’s Syndrome.

We encourage your husband or partner to accompany you whenever possible, as well as other family members to come for special ultrasound visits.

We realize not every pregnancy is uneventful. Amniocentesis, non-stress tests, and biophysical profiles are additional in-office diagnostic tests which we use to monitor the baby and demonstrate fetal well being. Sometimes your history may suggest possible risk factors or at some step along the way you may develop a condition that will make your pregnancy more complicated. We then will help to optimize your care by consulting and co-managing your pregnancy with maternal-fetal medicine specialists.

What to Expect at Each Stage of Pregnancy

The first few months of pregnancy — the first trimester — are marked by rapid changes for both you and your baby.   For you, first trimester physical changes may include breast tenderness, fatigue and nausea. Your emotions may range from excitement to anxiety. For your baby, the first trimester is a time of rapid growth and development. Your baby’s brain, spinal cord and other organs begin to form, and your baby’s heart begins to beat. Your baby’s fingers and toes even begin to take shape.   Your first appointment will be to confirm that you are pregnant. We will take an extensive medical history, we will do a number of blood tests, all to confirm that you and your baby are healthy and progressing. We may do a sonogram as well. We will be able to determine your approximate due date at this time.
During the second trimester of pregnancy — from months four to six — you may feel better than you did at first. Now’s the time to enjoy your pregnancy!   During the second trimester, your baby may begin to seem more real. Second trimester signs and symptoms may include larger breasts, a growing belly and skin changes. For your baby, the second trimester often marks the ability to kick, make facial expressions and hear. By week 20, you’ll be halfway into your pregnancy.   We will see you in the office every 4 weeks. Between weeks 20-24 you will be scheduled for a 1-hour glucose test. You will also have a sonogram, which often allows you to learn the sex of your baby.
The last few months of pregnancy — the third trimester — can be physically and emotionally challenging. Third trimester signs and symptoms may include backaches, swollen ankles and mounting anxiety. During the third trimester, your baby will likely open his or her eyes and pack on the pounds. This rapid growth may lead to more pronounced fetal movements. By the end of week 37, your baby is considered full term. During the third trimester, we will see you first every two weeks, and then once a week. We will begin to check your cervix and continue to monitor your baby’s development.

Common Questions of Expecting Moms


The glucose tolerance test is performed between the 24th and 28th week of your pregnancy and is used to test for gestational diabetes, a high blood sugar condition that affects some women during pregnancy.

Tylenol as directed. Click here for a list of approved over-the-counter medications.

Begin by increasing fluids, exercise (such as walking), and try a cup of prune juice at night. If no relief in 24-48 hours, you may take milk of magnesia or Surfak and continue with 1 cup of prune juice at night. If no relief in three to four days, call our office.  Click here for a list of approved over-the-counter medications.

Tylenol products as directed on the bottle.  Click here for a list of approved over-the-counter medications.

Robitussin DM as directed.  Click here for a list of approved over-the-counter medications.

If you are 1-12 weeks pregnant, use Tylenol allergy/sinus or Benadryl. If you are 13-14 weeks pregnant, you may use Sudafed, Tylenol allergy/sinus, or Benadryl.  Click here for a list of approved over-the-counter medications.

Postpartum continues for up to four to six weeks after a vaginal delivery and four to eight
weeks after a C-section.

It’s OK to have cats in the house, but avoid contact with litter or feline excrement while you are pregnant.

All fish should be limited to 12 ounces per week. You may have tuna, but no more than 12 ounces of fish in total. Luncheon meats from the deli are OK if heated. Foods to be avoided are cheese that is soft or unpasteurized, tile fish, shark, and kind mackerel.

Weight gain of about 20-25 pounds is recommended for average weight women. Each pregnancy is different, so recommended weight gain will vary. Your physician will monitor your individual weight.

No new exercise routines. You may continue your current exercise routine unless otherwise directed by your physician. Try to keep your heart rate below 150 bpm.

Travel is not recommended after 32 weeks. Be certain to move around every 1-2 hours, and keep your legs moving.

While most of the time it is normal to spot in the first trimester, please contact our office if the bleeding is like a period or accompanied by any pain.

Monistat 7 Day or 3 Day treatment. If symptoms persist, please contact our office.  Click here for a list of approved over-the-counter medications.

Yes. Follow the instructions and make sure the area is well-ventilated. A mouth covering, such as a dusk mask or scarf, is recommended.

More information is available from the Cord Blood Registry. http://www.cordbankingbasics.com

We want to support you in your decision to become prepared and educated for your childbirth experience. Through education you will gain important knowledge about what to expect and how to prepare for your big day. Our parent education classes are offered to not only the expectant parents but also to grandparents and siblings as well. This is an exciting time for you AND your entire family. We look forward to having you join us and our specialized nurse educators as we help prepare you and your loved ones for your upcoming delivery.
Courses include:
• Sweet Beginnings
• Preparation for Childbirth
• Cesarean Section Class
• eLearning Parent Education
• Lamaze Class
• Refresher Childbirth
• Breastfeeding Class
• Breastfeeding and the Working Mother
• Baby Bump Yoga
• FREE Hospital Tour
• And many more…
Use these links for more information or to register.

Contact parent education at 972-566-7153, or email Stephanie Howard.

IMPORTANT INSURANCE/BILLING INFO

We contact your insurance company once you have visited our office confirming that you are pregnant. We verify your benefits, and determine your out of pocket medical expenses to our office. We recommend you contact your insurance company as well, so you can be prepared for the out of pocket costs associated with your pregnancy.

We contact your insurance company once you have visited our office confirming that you are pregnant. We verify your benefits, and determine your out of pocket medical expenses to our office. We recommend you contact your insurance company as well, so you can be prepared for the out of pocket costs associated with your pregnancy.

We bill our services for your pregnancy globally, which means that we bill for our services related to your office visits, the delivery and postpartum care AFTER your delivery. The exception to this is sonograms and lab services. Sonograms and lab tests are billed by us and the lab (Quest, Labcorp, Propath) when they are performed. This can be confusing, because you will be paying us your estimated fees, but they will not be credited on statements you receive from your insurance company. Save all your receipts from our office documenting your payments, or we can provide you with a summary of your payments.

Our charges will go in to your insurance company AFTER you have delivered, and if there is a small balance or refund, we will notify you after your claim has been paid to our office. We generally submit charges the week of your delivery, and wait 30-45 days for your insurance company to pay your claim. Please notify your insurance company after your delivery as they require to facilitate the claims process.

We calculate your out of pocket expenses to our office, and give you a written estimate of what we calculate these expenses to be. We collect our portion of your out of pocket expenses by your 7th month of pregnancy. We accept cash, checks, and all major credit cards.

Your pregnancy and delivery will create other expenses outside our office that you will be responsible for. These include, but are not limited to, the lab (Quest or Labcorp), the hospital (Medical City Dallas), anesthesia, prenatal specialists, and your pediatrician. You can contact them to get estimates on out of pocket expenses they will bill for in relationship to your pregnancy.