Frequently Asked Questions

How do I get in touch with the doctor?

Getting in touch with us is very simple, just dial our main office number (919)678-6900 and follow the instructions.

What are the signs of Labor?

Labor is defined by regular contractions causing cervical change. Contractions will typically start far apart and progressively become more frequent and stronger over time. As contractions become closer, they will also increase in intensity and duration. Once you begin to have contractions, typically they last one minute from the start to the end of the contraction. Once they are five minutes apart give us a call and let us know. Your water may break once this process has begun or before you show any signs of labor. If your water breaks at any time, let us know so that we may advise you further. Finally, if you have any heavy bleeding towards the end of your pregnancy please call us.

What do I do if I think I am in labor?

It is important that you call us if you think you might be in labor. We can often help you determine where you are in labor and whether you need to be seen. If we determine that you need to be seen, we will call to make the arrangements.

What can I use for pain control during labor?

Pain control options are numerous. They range from breathing techniques and meditation to epidurals. Most people don’t know what will work for them until they are actually in labor. So, it is important to keep your options open. Natural methods may include techniques such as controlled breathing, use of the birthing ball, Jacuzzi baths, showers, reflexology massage, and acupuncture. These methods might not be adequate for all people. Pharmacological methods include the use of narcotic analgesics and epidural anesthesia. All of these methods are safe during labor.

When is it safe to travel by air during pregnancy?

Air travel is safe for most women up to 36 weeks of gestation. Most US carriers allow domestic travel up to this time. It is important to check with your individual carrier to determine their rules. Most international airlines allow travel up to 35 weeks of gestation. If you have any complications during your pregnancy, air travel may not be recommended. Please check with us to determine if air travel is recommended for you. If you are deemed to be a good candidate for air travel, several precautions can be taken to make your travel more comfortable. Gas producing food and drink should be avoided before scheduled flights. If you have nausea or air sickness, an anti-nausea medication may be helpful. Support stockings and movement of the lower legs may help to prevent blood clots in the legs. Since air turbulence cannot be predicted, seatbelts should be used continuously while seated. Seatbelts should be low on the hips below your belly.

When is it safe to travel by car during pregnancy?

The guidelines for automobile travel are very similar to those for air travel. In general, it is okay to travel up to 36 weeks, assuming that you have an uncomplicated pregnancy. It is important to keep in mind that if you do have complications while you are away, especially between 24 and 34 weeks, that require delivery of your baby, your baby may require an extended hospital stay, which may be very inconvenient for your family.

What are common over-the-counter medications that I can use during pregnancy?

It is best to avoid all over-the-counter medications during pregnancy, especially the first three months; however, if necessary, the following treatments are thought to be safe for you and your baby.
All herbal remedies should be avoided!
Call your doctor IF:

  • You can’t keep liquids down for 12-24 hours
  • You have abdominal pain, dizziness, extreme weakness
  • You have a fever of 100 degrees or higher
  • You develop a rash
  • You experience pain or burning with urination
  • You cough up or blow out yellow or green-colored mucus
Colds/Congestion Oral decongestants (guaifenesin)
1st trimester: Tavist (plain) Afrin spray (3 days) No Sudafed
2nd trimester: Tylenol Cold, Actifed, Triaminic (all types), Benadryl, Claritin(plain)
Drink at least 80 oz. fluid daily and use vaporizer or humidifier; Breathrite Strips (anytime)
Sore Throat/Cough Throat sprays, lozenges, Zyrtec 2nd trimester: Robitussin, Triaminic Honey and lemon, tepid fluids
Headache/Fever Acetaminophen (Tylenol). Avoid aspirin, ibuprofen, and naproxen Take a nap, cold compress to head or back of neck
Nausea/Vomiting Emetrol, Pepto Bismol, vitamin B6 50mg twice a day and 50mg at bedtime Eat saltine or whole wheat crackers before getting out of bed. Use seabands
Diarrhea Kaopectate, Imodium Increase fluid intake, avoid high fat, spicy foods
Indigestion Antacids, Titralac, Mylanta, Tums, Maalox Avoid high fat, spicy foods, eat smaller, more frequent meals; drink fluids between meals
Constipation Stool softener- Colace (docusate) or fiber laxative (avoid stimulant laxatives)- Metamucil, Citrucel Drink at least 80 oz water daily; increase exercise; increase intake of fiber (prunes), fresh fruits, and vegetables
Frequent Urination Avoid coffee and tea
Hemorrhoids Anesthetic ointment, preparation H, tucks Warm sitz bath

When do I pick a pediatrician?

We like you to have chosen a pediatrician by approximately your 32nd week. Once you come into the hospital in labor, the hospital staff will ask you which pediatrician you have chosen and they will alert their office of your delivery.

Dr. Pearce was attentive, listened well, and provided a comfortable experience for me. My recent vaginal exams have been very uncomfortable and she provided a very comfortable exam this time.

Dr. Pearce was AMAZING! She answered all my questions and didn’t make me feel rushed. Best experience I’ve had at Triangle yet! She really put my worried first-time mom mind at ease.

I think Dr. Grana and her assistant (Mandy) are the best. I have been going to TP4W for years – at least 20, and I have never been disappointed with the level of care I have received. I can be a challenge as my level for pain tolerance is low and they put up with me! I can’t help but highly recommend the practice to anyone looking for exemplary women’s healthcare.

Love love love Dr. Grana and her crew. Love going to Holly Springs office. The girls are the best from Lisa at the front desk to all the girls in the back. Your music and atmosphere is great. Thanks for making these appointments fun!! Yes believe it or not, fun!!!

Dr V and the office staff were all very professional, understanding, caring and very efficient. I would be happy to recommend this practice to friends, family and associates. – Barbara M. Lucas

My visit was great! & my past visit have all been great.Kristy helped me even with me being a bit stressed & in a hurry because I had to be seen & my job is super strict. Her urgency to get me seen was phenomenal. I even got to see Heather, she’s awesome & amazing. She helped deliver my baby girl a year ago. My whole family loves her and Dr Sheshadri. We actually can’t wait to get pregnant again hahaha. Everyone treats you with respect and always makes sure your okay & answers whatever questions you have before you leave. Even leaving a message for the nurses,they get back to you so quickly.  This practice really makes you feel taken care of.  We appreciate you all!  – Erika Hooks

My experience with the TP4W staff has been top of the line.  They helped me through three pregnancies and coached me through every step of the way.  Eternally thankful I chose TP4W.  – Britney

TP4W have such amazing doctors, midwives and nurses.  I cannot say enough about Dr. Grana and the rest of the staff for all the help, advice, guidance and medical care they provided me with all of my kids.  She made me feel safe and calm through both c-sections.  My routine care and pregnancy care have always been top notch and I would recommend them to anyone looking for an OBGYN.  – Brooke

We were honored to receive a hand written note..

Dr. Grana, Angie, Jessica, Heather, April, Sarah and the rest of the staff –

Thank you all so much for taking such good care of me through both of my pregnancies and births, especially my latest one on 10/29! most of yall know how nervous I was from having gone through a lot (to say the least) with my first in 2016. You all made me feel so comfortable and at ease before, during and after. And going through a touch year with my dad, you guys always asked how he was doing at every appointment, which was so thoughtful and beyond your job description. I know that you all see many women go through what i did each and every day and deliver many babies and perform many c-sections. But I hope you know how special Ruby’s delivery was to me. You all have amazing jobs! I cannot thank you all enough. Merry Christmas!

Love, Lucy

I have been going to TP4W since 2010/11 and could not be happier.

The staff, nurses, midwives, and doctors are all amazing. I have 2 sons, both delivered via cesarean by Dr. V. Every visit and every provider did everything in their power to give me the birth experience I wanted, and also ensure that myself and my babies were safe and healthy. Dr. V even did everything in his power to help me avoid my first c-section and VBAC with the second, but that turned out to be out of his hands and he was the absolute best surgeon. With my two pregnancies, I experienced a few scares and some unusual circumstances that would be too long and too private to write in a review, but every single hurdle was handled with grace, honesty, and professionalism. I am so thankful for the recommendation from a friend to come to this office. I can’t imagine ever going to another practice.