Feeling nervous?

No need to worry. Our specialists are here for you every step of the way, no matter the complication.

Maternal-Fetal Medicine (MFM)

Advanced care for unique and challenging pregnancies.

Miracle Babies

Jeremy and Bonnie with their identical twin girls from the same amniotic sac—an uncommon and high risk type of twin that can result in the loss of both babies.
“We just had a lot to process because we wanted to get excited about the pregnancy, but there was a also a lot of fear.” — Bonnie

What is a Maternal-Fetal Medicine (MFM) Specialist?

Maternal-Fetal Medicine (MFM) specialists are high-risk pregnancy experts who oversee complicated pregnancies. MFM physicians work collaboratively with other clinical specialists including certified nurse midwives, nurse practitioners, physician’s assistants, and general obstetrician-gynecologists  to keep expectant  moms safe and healthy prior to, during and shortly after pregnancy. Our specialists offer prenatal ultrasounds and related screening and diagnostic tests, develop interdisciplinary care plans. administer treatments and  perform surgeries depending on the type and severity of complications.

Patients are referred to one of our MFM specialists if she and/or her baby are prone to serious health risks during pregnancy or following delivery. These women meet with our MFM physicians for a consultation, an ultrasound exam or perhaps both. Since there are many different types of appointments available, our staff will work with your healthcare provider to ensure that you are scheduled for the appropriate type of care.

There are several reasons why you would need to consult with an MFM physician during your pregnancy. You may be referred to us if:

  • You have a preexisting medical condition or one that has developed during pregnancy (e.g. diabetes, high blood pressure, kidney disease, hypertension, autoimmune disorder, thrombophilia, etc.)
  • You have a history of complications during pregnancy or delivery (e.g. incompetent cervix, preterm labor, preterm birth, preeclampsia, alloimmunization, premature rupture of the membranes, etc.)
  • You have a history of pregnancy losses
  • You are expecting more than one baby (twins, triplets, quadruplets, etc.)
  • You have had previously, or are expecting currently, a baby with a structural or genetic difference

If you exhibit any of the above at-risk conditions, you will meet with an MFM physician to review your medical, previous pregnancy and family history. Any current or expected complications during your pregnancy will be discussed and a physical exam will be performed, if necessary. Our specialists will be happy to discuss any potential maternal and fetal risks with you in detail and make recommendations for tests and/or treatments to improve the likelihood of a successful pregnancy.

 

Genetic counseling is available for women who are currently pregnant or considering having a child in the future. MAHEC partners with the Mission Fullerton Genetics Center to provide the highest quality care for our at-risk patients. You may meet with a genetic counselor if:

  • You will be 35 years of age or older at the time of delivery
  • Your ultrasound results reveal a known or suspected structural birth difference
  • You receive an abnormal prenatal or genetic screening test result (e.g. First Trimester Screen, Quad screen, cell free fetal DNA screen, cystic fibrosis screen, etc.)
  • You have an illness that may be associated with an increased risk for structural birth differences (e.g. diabetes, PKU, etc.)
  • You are taking medication that may be associated with an increased risk for structural birth differences (e.g. seizures, autoimmune disease, etc.)
  • You have been exposed to something that may be associated with an increased risk for structural birth differences (e.g. drug/alcohol use, chemicals, certain infections, etc.)
  • You have a family history of genetic conditions, chromosome or structural birth differences (e.g. cystic fibrosis, sickle cell disease, open neural tube, etc.)
If you are pregnant and struggling with a substance use disorder (drug/alcohol addiction), please visit MAHEC Project CARA to learn more about treatment options, specialty obstetric services, medication assisted treatment, counseling and other community resources.
 

Depending on the reason for your visit, you may have an ultrasound performed as part of your initial appointment with one of our MFM specialists. Ultrasound is an important diagnostic tool that can help evaluate fetal health. Ultrasound is used to:

  • Document the number of babies in the uterus
  • Measure the size of the baby to predict the due date
  • Observe the baby's growth rate by making many measurements over time
  • Check the location of the placenta and its attachment to the umbilical cord
  • Determine whether or not there is an appropriate amount of amniotic fluid around the baby
  • Evaluate fetal organ systems and well-being
  • Determine the position of the baby to see if it is in the normal, head-down position in time for labor
  • Monitor the baby during specialized procedures, such as amniocentesis (sampling of the amniotic fluid with a needle for genetic and other testing)

 


 

Meet our Maternal-Fetal Medicine Team

Our dedicated staff is made up of the only board-certified MFM physicians in the region aided by two exceptional nurse practitioners with special expertise in high risk obstetrics. This team specializes in providing care for women who are ’at risk’ and considering pregnancy or those who are already pregnant and ’high-risk’ or complicated for a variety of reasons. We see patients who are undergoing diagnostic or therapeutic procedures such as comprehensive ultrasound, chorionic villus sampling, and genetic amniocentesis. We also consult  on patients with medical and surgical disorders coincident with or prior to pregnancy including heart disease, chronic hypertension, diabetes and other endocrine disorders, kidney and gastrointestinal diseases, and infectious diseases. Otherwise healthy women who may require these services are those whose pregnancies are at markedly increased risk for adverse outcomes such as those with abnormal serum screens, multiple gestations, recurrent preterm labor, premature rupture of membranes, or growth abnormalities of the fetus.


Carol Coulson, MD
(Head of MFM)


Zachary Bowman, MD
 


Kathryn Davidson, MD
 


Jennifer Warren, MD

 

Heather Miracle,
WHNP-BC

 

Melinda Ramage,
BSN, MSN, FNP-BC

 

Meet our Ultrasound Technicians


Kelly D.


Vicki E.

Sharen F.


Amy F.


Stephanie G.

Megan H.


Marcia J.


Lisa M.

Kim M.