R Michelle Chouteau, M. D & Jo Bess Hammer, M. D. Obstetrics & Gynecology




A note from Dr. Chouteau

Thank you for choosing my office for your prenatal care. We strive to reward your trust in us by providing you with personalized state-of-the-art care in a comfortable setting. During the beginning of your pregnancy, your appointments will be every 4 weeks, at approximately your 28th week, I will see you every 2 weeks and then every week starting with your 35th week. Pelvic examinations will begin at 35 weeks to determine the baby’s position and evaluate your cervix.
If you have any problems or questions, please call the office, as soon as possible, so that we can assess your status.
Frequently asked questions:


There is no medication that is considered 100% safe for long-term use in pregnancy. Each
medication carries certain risks and benefits. Therefore it is recommended that you limit the use
of medications unless it is absolutely necessary and only take medications for the minimum
number of doses required.
These medications and remedies are recommended when needed for the following discomforts:
Allergies: Benadryl, Tavist, Claritin,or Zyrtec
NO decongestants
Anemia: Iron supplements (i.e. ferrous sulfate) taken with orange juice or Vit C
Cold/Fever: Tylenol, Vit C
Increase fluids and rest. Call our office if you have a fever over 100.4 for
more than 48 hours or over 102 at any time.
Congestion: Benadryl, Tavist, Robitussin DM, Mucinex Zyrtec or Claritin
NO Decongestants of any type.
Cough: Robitussin DM, Mucinex DM
Constipation: Colace or Surfax, Fibercon, Citracel, Metamucil, Milk of Magnesia, Fleets enema.
Prunes, prune juice, raspberry leaf tea.
Increase fiber (whole grains, bran, fruit & vegetables) Increase fluids (water or
Diarrhea: Immodium, Kaopectaete
Headache: Tylenol, Meditation, relaxation, biofeedback, massage, application of moist heat
or cold. Rest, Identify triggers, don’t skip meals.
Call the office if any headache is unrelieved by Tylenol or if headache is
accompanied by visual changes.
Indigestion: Maalox, Mylanta, Tums Riopan, lemon balm tea, slippery elm tea.
Avoid spicy, acidic or salty foods. Eat small frequent meals.
Hemorrhoids:Anusol HC cream or suppositories, Tuck pads
Kegels, ice pack, sitz baths, witch hazel, catmint(externally), calendula
Avoid constipation. Report painful or bleeding hemorrhoids.
Herpes: Domeboro soaks, sitz baths, Zovirax ointment (Rx), Xylocaine gel, Valtrex 500
mg(Rx) 500 mg 2x day for 5-7 days.
Gas: Mylanta, Mylicon
Insomnia: Benadryl, Zyrtec, lemon balm tea
Nausea: Vit B6-200 mg daily, Vit C 1000 mg daily, Emetrol, peppermints, raspberry leaf
tea, lemon balm tea, peach bark tea, rosemary
Eat small, frequent meals, bland food, Warm liquids between meals only.
Increase food with vit B & C (whole grains, citrus fruits). Avoid alcohol, caffeine,
salty, spicy or acidic foods. Call the office if vomiting is severe or persistent.
Sore throat: Cepacol lozenges, Vit C, slippery elm.
Gargle with warm salt water or Listerine.
Skin Irritation:Benadryl lotion, Calamine or Caladryl lotion, Corticaine, Lanacort, Neosporin
ointment, Zinc oxide.

Should I take a multivitamin?

It is very important that you take a daily prenatal vitamin. Over-the-counter prenatal vitamins are fine unless you tend to be anemic. Prescription prenatal have more iron in them. Please call our office if a sample or prescription disagrees with you or does not fit into your budget.

What lab tests are done during pregnancy?

At your first visit, you will have the following lab tests done: Blood type, Rh Factor, Complete blood count, STD testing, including HIV, Pap smear, Rubella immunity(German measles) and urinalysis. These test should be done early in your pregnancy and do not require fasting. At about 12 weeks a “first screen” is offered to screen for Down Syndrome and Trisomy 18(chromosomal abnormalities). At 15-20 weeks, we offer the QUAD screen, an optional tests that assess risks for certain birth defects (Down Syndrome, Trisomy 18, or an open neural tube defect, such as Spina Bifida or Anencephaly). At 26-28 weeks, we order gestational diabetes screening, hemoglobin and hematocrit to check for anemia and if for Rh negative blood types, a Rhogam study. At 35 weeks a test for Group B Strep will be done using a vaginal swab. In some patients, additional tests may be needed.

Can I exercise during my pregnancy?

Exercise is very important to both you and the baby. If you stay active you will feel better. Outdoor exercise and recreation give you a chance to get sunshine and fresh air. Walking, swimming, aerobics, yoga, and bicycling are good choices because they strengthen some of the muscles you will use in labor. You need to exercise approximately 4 times per week for 30-40 minutes each time. If you already have an exercise routine, please discuss this with me.

What can I do for nausea and vomiting or morning sickness?

Nausea and vomiting are common complaints during the first 3 months of pregnancy and are usually due to hormonal changes occurring in your body. About 50% of all pregnant women experience this problem. Nausea may start about the 6th -7th week, but seldom continues beyond the end of the 14th week. Although often called ‘morning sickness’ this may occur at any time of day. IF VOMITING IS SEVERE AND YOU ARE UNABLE TO KEEP FLUIDS DOWN, REPORT THIS TO MY OFFICE IMMEDIATELY. Never take prescription drugs, over-the-counter medications, or home remedies unless recommended by your doctor.

Helpful tips for dealing with nausea and vomiting: You may find some relief by eating Popsicle, dry cereal, a piece of toast or crackers about 30 minutes before getting out of bed in the morning. Move slowly when you do get up. Let plenty of fresh air into the house to get rid of cooking and other household odors. Divide your food into 5 small meals rather than 3 larger ones, since keeping food in your stomach often controls the nausea. Avoid greasy and highly seasoned foods or any food that disagrees with you. Drinking liquid between meals instead of during meals may help.

What can I do about constipation?

Constipation is also due to hormonal changes that tend to relax the muscles of your digestive system. Late in pregnancy, the growing uterus pressing on the lower intestines may cause constipation.
Helpful tips for dealing with constipation: Drink 6-8 glasses of liquids per day. A glass of water or juice before breakfast is often effective. Eat foods that provide fiber such as: whole grains cereals and breads, and raw fruits and vegetables. Exercise daily. Make a habit of going to the bathroom every day at the same time. Metamucil, Benefiber, and Citrucel are good fiber sources and can be used as a preventative therapy for constipation throughout your pregnancy. If you continue to be troubled, contact our office. Do NOT take enemas, laxatives or home remedies unless recommended by your doctor.

Can I smoke during pregnancy?

NOT smoking is one of the best gifts your can give your unborn child. Women who do smoke during pregnancy is directly associated with low birth weight, premature births, miscarriage, cesarean sections, and other complications.

Can I drink during pregnancy?

Alcohol in any form can be harmful to a developing baby. There is no known safe amount of alcohol you can consume during pregnancy. The Surgeon General has recommended that all women of childbearing age take the following precautions:
Do not drink alcoholic beverages when you are pregnant. In the crucial early period of a baby’s development-often before pregnancy is recognized-maternal consumption of alcohol increases the risk of abnormalities. Be aware of the alcohol content of food and drugs.

How much weight should I expect to gain during pregnancy?

If you have started your pregnancy at a normal weight range, weight gain should be 25-35 pounds depending on the individual. If you are overweight, less weight gain is recommended and if you are underweight more weight gain is needed. Please discuss this with me at your visit.

How do I contact the office?

During normal business hours you can contact us at 512-477-1954. After 5 pm and on weekends you can call the Medical Exchange at 512-458-1121. I take my calls during the week but on weekends I share call with the following doctors: Dr. Noble Doss, Dr.Jeffrey Youngkin, Dr. Allison Urrutia, Dr. April Harris , Dr. Robert Crumb and Dr. Delia DeLeon

Does St. David’s Hospital offer tours and prenatal classes?

I deliver babies at St David’s Hospital on 32nd Street. I strongly recommend the prenatal classes that are offered to aid in your delivery. Please see the handout given to you at your first visit or you can visit www.Stdavids.com.

Do I need a pediatrician before delivery?

It is recommended that you choose a doctor for your baby by the 28th week of your pregnancy. If you do not choose one before delivery then the on call pediatrician will be available. We can offer you a list of pediatricians; it is your responsibility to call them prior to delivery to confirm the one you choose is accepting new patients and is on your insurance plan. Many insurance plans pay for a prenatal visit to meet your pediatrician I advise you to take advantage of this.

How are my visits and delivery billed to my insurance?

Dr. Chouteau will bill your insurance at the time you deliver for you OB Care, which includes all your prenatal and postpartum visit and delivery. We try to estimate your portion of these charges; however, your insurance company will not guarantee payment until claim is submitted. Dr. Chouteau’s office policy is that you make monthly payments with the final payment due no later than the 32nd week of pregnancy. . If there is any problem with making payment by 32nd week of pregnancy, please contact Dency Barrera at the office to make arrangements. Please be advised that our charges will go to your insurance before the hospital charges, therefore the deductible will be taken from our fees. Please inform the hospital that you have met either all or a portion of your deductible with us. You will also need to contact your insurance with an estimated delivery date and inquire about precertification. If you are having a male child and if a circumcision is to be done that will be in addition to your delivery charges. ANY DISPUTES WITH YOUR INSURANCE ARE YOUR RESPONSIBILITY.