Preparing for birth and parenthood
Whether you are expecting your first child or your fourth, our patient education resources are designed to help prepare you for your hospital stay, childbirth, recovery and caring for your new baby.
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It is a good idea to pack for your trip to the hospital one month before your due date. If you have other children, arrange for their care while you are away. What to bring:
- Insurance card
- Social Security information
- Robe and slippers
- Lip balm
- Toothbrush and toothpaste
- Warm socks
- Contact lens case and solution
- Hair clasp for long hair
- Camera/video recorder (with extra batteries)
- Hair dryer
- Four to six pairs of underwear
- Two to three nightgowns
- Two to three bras
- Shampoo, conditioner and shower gel
- List of phone numbers for people you’ll want to call
- Clothes to wear home for you and baby
- Blankets for the baby
- Car seat
Leave your valuables at home, including watches, rings and other jewelry. Diapers and sanitary pads are supplied by the hospital during your stay.
Childbirth preparation classes are designed to provide you and your support person with the information and skills you need to approach the birth process with confidence and skill. Discussions include:
- Discomforts of late pregnancy
- Anatomy and physiology
- Stages of labor
- Pain management: breathing and relaxation
- How to prepare for labor
- Possible complications
- Cesarean sections
- Postpartum and newborn care
- Infant feeding, basic breastfeeding
All mothers will have their babies in their rooms as much as possible. If mother or baby is ill and requires special care, other arrangements may be made.
Having your baby with you will help you learn to care for him or her with the nurse's help and guidance. You will be able to care for your baby at your own pace.
While caring for your baby over a consistent period of hours, you will begin to learn the meaning of his or her behavior and how to meet your baby's needs. You will have an opportunity to feed your baby when he or she is hungry, to handle, hold and rock your baby when he or she needs attention, and to become well acquainted with your baby's reactions.
Learning about yourself and baby
From the time your baby is born, your nurse will be teaching you how to care for your newborn and yourself. Your nurse will give you a discharge instruction packet. The packet is designed to provide information about breastfeeding, bottle-feeding, newborn care and postpartum/home care. Other topics about home care are included in this packet.
Television programs on mother and baby care also are available on closed circuit TV channel 20 in your room. Fathers and other family members also are encouraged to watch.
A medical records clerk will come to your room with a birth certificate worksheet to fill out. A formal copy will be made from this worksheet and filed with the state. You may order this official copy three months after the baby is born.
If you have questions about the birth certificate, call our Medical Records Department at 404-686-2482.
Baby pictures are taken soon after delivery for security reasons. The baby picture is taken in a souvenir Emory University Hospital Midtown t-shirt. If there is a special outfit that you would prefer your newborn to wear for the picture, tell your nurse and bring it with you.
If you would like, your baby's photo can be placed on the hospital's website for family and friends to view. You are able to password protect your baby's picture so that only family and friends with the password have access to the photos.
If you have any questions about purchasing the pictures, a representative will visit and answer questions.
To safeguard your newborn, an infant security transmitter will be applied to your baby's arm. You and one (1) support person will be issued identical armbands with the same number. Do not remove the armbands until you are released from the hospital. If your baby has to stay, plan to keep your armband until the baby is discharged.
Never leave your baby unattended, even if you go to the bathroom. Take the baby with you. Let the nurse know if you plan to leave the room for any reason. Your baby may go to the nursery while you are gone.
Never give your baby to anyone unless they are wearing an Emory University Hospital Midtown photo ID badge. Remember if anyone needs to see your baby for any reason, make sure you know who they are and why they need to see your baby. Call your nurse if you have doubts about anyone.
Be sure you know your nurse's name and you are familiar with anyone who cares for your baby. If you do not know the person who comes to the room to ask about the baby, call your nurse right away. Don't delay.
If your baby has to have tests, find out how long they take, who is doing the tests and why. Most tests can be done in the room. If you are in doubt about anyone entering the room, call the nurses' station right away.
Always use a bassinet to transport the baby in the halls and to the nursery.
Because of the Georgia state law requiring the use of an approved car seat at all times, all babies must be in car seats when they leave the hospital. It is Georgia law that all children under the age of three be placed in a safety seat.
The recommended place for the car seat is in the middle of the backseat facing to the rear of the car with the seat at a 45-degree angle or less.
Someone should be able to see the baby at all times. The car seat should be secured and belted according to the manufacturers' recommendations.
Emory Healthcare does not provide infant safety seats. Please know how to operate your infant safety seat and practice how to put the baby in and adjust the straps before discharge.
If you get home and have questions about self-care, breastfeeding, bottle-feeding or baby care, you may call us at 404-686-2237. If you think that either you or your baby is sick, please call your doctor as soon as possible for instructions.
Circumcision is an elective surgical procedure in which the skin covering the end of the penis is removed.
If desired by an infant's parents, circumcision is typically performed by one of our obstetricians at some point during the postpartum hospital stay. An infant must be stable and healthy to safely be circumcised.
Scientific studies show some medical benefits of circumcision. However, these benefits are not sufficient for the American Academy of Pediatrics to recommend that all infant boys be circumcised.
Parents may want their sons circumcised for religious, social and cultural reasons. Since circumcision is not essential to a child's health, parents should choose what is best for their child by looking at the benefits and risks.
Research studies suggest that there may be some medical benefits to circumcision. These include the following:
- A lower risk of urinary tract infections (UTI). A circumcised infant boy has about a 1 in 1,000 chance of developing a UTI in the first year of life; an uncircumcised infant boy has about a 1 in 100 chance of developing a UTI in the first year of life.
- A lower risk of getting cancer of the penis. However, this type of cancer is very rare in both circumcised and uncircumcised males.
- A slightly lower risk of getting sexually transmitted diseases (STD), including HIV, the AIDS virus.
- Prevention of foreskin infections.
- Prevention of phimosis, a condition in uncircumcised males that makes foreskin retraction impossible.
- Easier genital hygiene.
Just as there are reasons parents may choose circumcision, they are reasons why parents may choose not to have their son circumcised:
- As with any surgery, circumcision has some risks. Complications from circumcision are rare and usually minor. They may include bleeding, infection, cutting the foreskin too short or too long, and improper healing.
- The belief that the foreskin is necessary to protect the tip of the penis. When removed, the tip of the penis may become irritated and cause the opening of the penis to become too small. Rarely, this can cause urination problems that may need to be surgically corrected.
- Some people believe that circumcision makes the tip of the penis less sensitive, causing a decrease in sexual pleasure later in life. This has not been proven by any medical or psychological study.
Almost all uncircumcised boys can be taught proper hygiene that can lower their chances of getting infections, cancer of the penis and sexually transmitted diseases.
Is it safe for me to exercise during pregnancy?
It's probably safe, but you should check with your doctor first. Although we don’t know all the answers about the effects of exercise on pregnant women, there is no proof that gentle exercise has any bad effects on pregnancy.
Studies haven't shown any benefits for the baby, but gentle exercise might help you feel better.
If you have no serious medical problems and you have an uncomplicated pregnancy, it's likely safe for you to exercise.
How should I start an exercise program?
It's best to check with your doctor before starting any exercise program. You may have a medical condition that would make exercise harmful to you or your baby.
If your doctor approves, you can start exercising at a level that does not cause pain, shortness of breath or excessive tiredness. You may then increase your activity slowly.
If you feel uncomfortable, short of breath or very tired, you should reduce your exercise level. If you have been exercising already, it's easier to keep exercising during a pregnancy. If you haven't exercised before, you need to start very slowly. Many women find that they need to reduce their level of exercise during pregnancy. This is common.
What types of exercise are best?
The most comfortable exercises are those that don't require your body to bear extra weight.
Swimming and stationary cycling can easily be continued throughout pregnancy. Walking and low-impact aerobics are well tolerated.
Running appears to be safe, but many women become uncomfortable and have to decrease or stop running in the later stages of pregnancy.
What should I be careful about?
Be careful to avoid activities that increase your risk of falls or injury, such as contact sports or vigorous racquet sports. Even mild injuries to the "tummy" area can be serious when you're pregnant.
After the first three months of pregnancy, it's best to avoid exercising while lying on your back, since the weight of the baby may interfere with proper blood circulation. Long periods of standing should also be avoided.
When the weather is hot, it is best to exercise in the early morning or late evening to help you avoid getting too hot. If you're exercising indoors, make sure the room has enough ventilation. Consider using a fan to help keep you cool.
Drink plenty of fluids even if you don't feel thirsty. Also, make sure that you're eating a well-balanced diet. Normally, pregnancy increases your food requirements by 300 calories a day, even without exercise.
What problems should I tell my doctor about?
Tell your doctor right away if you have any sudden or severe abdominal pain, vaginal bleeding or spotting, or if you're having contractions that last for more than 30 minutes after you have stopped exercising.
You should also stop exercising and seek medical care if you have chest pain or severe shortness of breath.
We recognize that most pregnancies are low-risk and that most babies are born healthy. However, our genetic counselors can provide any interested patient with more information about genetic risk factors.
Please keep in mind that there may be others not listed below who may benefit from testing. Testing is usually not 100 percent accurate and it may not be covered by your insurance. You may obtain more detailed information about these diagnoses and many others at www.genetics.emory.edu.
Below is a summary of who may benefit most by testing, as well as some general information on the more common tests available.
- Screening tests do not provide a diagnosis, but rather a statistical risk of having a baby with a condition such as Down's syndrome.
- First trimester tests include blood tests (free beta-HCG and PAPP-A) combined with an ultrasound to evaluate some of baby's characteristics.
- Second trimester testing includes the maternal serum alpha-fetoprotein (AFP) quad blood test and the 20-week ultrasound/anomaly scan.
Age 35 and older for moms, age 45 and older for dads (younger if you have twins):
- Increased risk for Down's syndrome, Trisomy 18 or 13, or other extra chromosomes.
- An optional first trimester test is needle sampling of part of the placenta (CVS); or performing an amniocentesis during the second trimester.
Caucasians, especially those of Northern European descent:
- Increased risk for Cystic Fibrosis (CF) - 1 in 29 is a carrier, 1 in 3,300 will be diagnosed with CF. Carrier testing is by cheek swab or blood testing at any time.
- Increased risk for sickle cell disease. Testing is by blood test, typically done at the first prenatal visit.
Ashkenazi Jews (Eastern European descent):
- Increased risk (1 in 30) for Tay-Sachs, Gaucher, Canavan Disease, or Familial Dysautonomia. Testing is by blood test at any time, although accuracy is best prior to conception.
- The American College of Obstetricians and Gynecologists recommends screening only for CF, Tay Sachs, and Canavan disease in those who have Ashkenazi Jewish ancestry.
Unplanned pregnancy (due to no pre-pregnancy folic acid supplementation):
- Increased risk for neural tube defects (NTD), e.g. spina bifida and anencephaly. The risk is higher if there is a family history of NTD. Testing includes an AFP blood test, needle sampling of the amniotic fluid (amniocentesis) or ultrasound in the second trimester.
It seems that pregnancy calls for a whole new language sometimes. We’ve taken some of the most commonly used terms and explained them for you here.
- Analgesia: A substance that relieves pain.
- Anesthesia: The loss of sensation/pain with or without the loss of consciousness.
- Cesarean: When your baby is delivered through an incision in your lower abdomen and uterus.
- Cervix: The opening of the uterus.
- Contraction: The tightening and shortening of a muscle. In labor, alternating contraction and relaxation of the uterus. It brings about effacement (softening,thinning) and dilation of the cervix, and descent of the baby.
- Dilate: To stretch and enlarge the cervical opening.
- Episiotomy: A small incision made at the vaginal opening that may make it easier for your baby to be delivered.
- Epidural: A type of regional anesthesia that blocks sensation from the navel down by injecting anesthetic in the lower back area. It may be one injection or may be given continuously through a catheter lightly taped to your back or shoulder.
- Fetal monitor: A machine that records your baby’s heart rate and alerts the medical and nursing staff when there is a change in uterine activity or if your baby begins to have stress during labor.
- LDR: An abbreviation for labor, delivery and recovery. At Emory Healthcare, each suite is designed so moms can labor, deliver and recover in the same room. Each LDR room is equipped to handle routine deliveries as well as the most complicated ones.
- Lactation specialist: An advanced nurse whose focus is providing education and management to prevent and solve breastfeeding problems.
- Midwife: A master's degree nurse whose scope includes the care of low-risk pregnant women.
- Mother-Baby Unit: A special hospital room where mothers and babies (dads, too, if desired) stay together following routine delivery until discharge.
- Neonatologist: A pediatrician who specializes in caring for babies immediately after they are born until they are discharged from the hospital.
- Pediatrician: A doctor who specializes in caring for infants, children and adolescents.
- PKU (phenylketonuria): An inborn error in metabolism, when an infant cannot metabolize phenylalanine, an essential amino acid.
- Perinatal: Before, during and after birth.
- Perinatologist: An obstetrician who specializes in caring for mothers who may have a high-risk pregnancy or delivery.
- Perineum: The region between the thighs bounded in the female by the vulva (external vaginal region) and rectum.
- Postpartum: Refers to the time after you have delivered your baby. For example, after your delivery, you may be taken to the postpartum floor, which is just for moms who have delivered a baby.
- Prenatal: Before birth.
- Sitz bath: A pan of warm water you may sit in to help relieve any discomfort and begin the healing process.
- Tocotransducer: Pressure-sensitive gauge that measures the intensity and duration of uterine contractions.
Once you are in the third trimester (32 weeks of pregnancy or beyond), one of the best ways to be reassured that your baby is healthy is to feel a normal amount of baby's movement every day until your baby is born. Here are some guidelines for how much movement is considered normal:
- If you are paying attention to baby's movements, you should notice your baby moves (wiggles, squirms, rolls around, or kicks) at least 10 times in two hours if he or she is awake. Babies may sleep for a few hours, but never more than half the day should go by without movement.
- Choose at least two times per day to think about baby's movements. If you do not recall good movement then you may need to encourage your baby to move by eating, drinking something cold, making a little noise or gently massaging your belly.
- Please call your doctor or nurse midwife at any time if you feel like your baby is not moving enough or if your baby is moving less than usual. On the other hand, if you feel 10 movements in two hours or less, you'll know that your baby is doing great!
If you have any one of the following symptoms during your pregnancy, call your doctor right away.
- Bright red bleeding
- Abdominal pain that is severe or is worsening
- No fetal movement for more than half the day (refer to "How is Your Baby Moving?" above)
- Leakage of watery fluid
- Fever over 102 degrees Fahrenheit
- Shortness of breath, chest pain or pain in your legs
- Severe headaches, visual disturbances or fainting spells
The following medications/remedies can be used during pregnancy as needed and should be taken according to the directions on the package.
- Allergies: Benadryl, Claritin
- Congestion: Dimetapp, Benadryl, Sudafed or Actifed
- Constipation: Metamucil, Citrucel, Milk of Magnesia, Colace
- Cough: Throat lozenges, Robitussin
- Diarrhea: Clear liquids, Imodium AD, Kaopectate
- Heartburn: Tums, Maalox, Gaviscon, Zantac, Pepcid, Tagamet
- Hemmorrhoids: Tucks, Preparation H, Anusol HC
- Nausea: Sea Bands, ginger tea, Vitamin B6, Unisom (not gelcap)
- Pain: Tylenol (regular or extra strength)
- Sleeplessness: Benadryl, Tylenol PM
- Sore Throat: Saline gargle, Chloraseptic throat spray
For any other medications you may wish to take (including herbal remedies), please contact your doctor or ask about the medication's safety at your next prenatal visit.
We also recommend that you limit products containing caffeine.
Alcohol use during pregnancy has been associated with severe birth defects, including mental retardation. No safe level of alcohol has been demonstrated.
Cigarette smoking and second-hand smoke during pregnancy can cause low birth weight, prematurity, respiratory problems, and sudden infant death syndrome in newborns. Smoking has been associated with preterm labor and placental abruption, potentially life-threatening complications of pregnancy.
We cannot stress enough the importance of prenatal care as soon as you learn you are pregnant.
Preconception counseling also is a good way to ensure a healthy start for a healthy pregnancy. It is especially vital during pregnancy to watch the health of both you and your baby.
If you do not have an obstetrician or if you need a high-risk pregnancy specialist, call Emory HealthConnection℠ at 404-778-7777. Our staff will refer you to an obstetrician or family practice physician who can deliver your baby at Emory Healthcare. This physician referral service is fast, confidential and free.
If the baby's father cannot be here during your labor and birth, you may decide on another support person — either a family member or friend — to take his place.
This person will usually be permitted to stay with you throughout your labor and delivery.
We recognize that families are important to you at this exciting time. Our philosophy of family-centered maternity care is guided by the principle that the environment should be safe and comfortable for everyone.
Visitation in the labor and delivery suite is decided by you, the laboring woman, your physician and your primary nurse during labor.
Discuss a birth plan, a list of the options you prefer for your labor and for caring for your baby, with your physician, and with your support person. Investigate the types of medications and other alternatives there are for pain relief and, with recommendations from your physician, select what is best for you. During the last few weeks of pregnancy, write your birth plan. Making these decisions beforehand will make your hospital stay easier.
Before you are admitted to the hospital, know which doctor will care for your new baby. Your obstetrician can recommend a pediatrician if you do not know one. If the pediatrician you have chosen does not see babies at Emory Healthcare hospitals, our neonatologist will care for your baby while you are here.
If you have children at home, arrange for someone to care for them when it is time for you to go to the hospital. In fact, if your children will be staying away from home while you are in the hospital, pack their suitcase when you pack yours! Tuck in a small surprise, such as a new toy, and tell the sitter to let them unpack when they arrive at their destination.
To make your admission go as smoothly as possible, we ask that you complete one pre-admission form. These are available from your doctor's office or from the hospital. Fill out the form and return it to the hospital as soon as possible.
Bring your insurance cards anytime you come to the hospital. We will file up to two insurance plans as a courtesy. At the time of admission, an admissions representative will make a copy of your insurance cards.
If you do not have insurance, contact the business office early in your pregnancy to make financial arrangements.
You have probably heard of the many health benefits of eating fish: high quality protein, low in saturated fat and a great source of omega-3 fatty acids. While eating a variety of fish and shellfish can contribute to your health and to the healthy growth of your baby, eating the wrong kind of fish can actually be harmful to a baby's or a child's developing nervous system.
Nearly all fish and shellfish contain small amounts of mercury - such a small amount that the benefits of eating seafood far outweigh the risks. However, there are a few varieties that contain such high levels of mercury that they should not be eaten during pregnancy.
Guidelines recommended by the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) for eating fish during pregnancy include:
- Avoid shark, swordfish, king mackerel, or tilefish, as they contain high levels of mercury.
- Some fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish. Fish in fish sticks and in fast food sandwiches are commonly made from fish that are low in mercury also. Feel free to enjoy one of these types of fish at one or two meals per week.
- Tuna steaks and albacore tuna have slightly higher levels of mercury, and may be eaten once per week in place of another serving of seafood.
- If you are interested in eating seafood not listed above, you can visit the following websites to obtain more safety information: www.cfsan.fda.gov | www.epa.gov/ost/fish
Due to the timing of routine vaccinations, or because of employment or school requirements, many pregnant women are faced with the decision of whether or not to receive certain vaccines during pregnancy. In many cases, vaccines prevent infections that would otherwise be very harmful to both mom and baby.
Generally, pregnant women can safely receive vaccines made from dead viruses, from genetically engineered viruses, or from toxoids, which are chemically altered proteins from a bacterium. In contrast, live viruses should be avoided, as they can potentially cause harm to the baby. Please see below the 2005 guidelines presented by the Centers for Disease Control and Prevention (CDC).
- Influenza: If produced by an inactivated virus (as is usually the case), the vaccine can be received during any trimester and is recommended for every pregnant woman. While the flu does not harm the baby, the illness may cause more severe symptoms when a woman is pregnant
- Tetanus: Receive in the second or third trimesters if it is due (due every 10 years), or if exposure occurs (deep or dirty wound); generally includes diphtheria toxoid which is also safe
- Meningococcal or rabies: Recommended to receive if exposures occur
- Hepatitis B: Recommended if you work in healthcare or day care, or if you live with somebody who is infected with Hepatitis B
Vaccines to avoid during pregnancy (these vaccines may harm the baby):
- Measles, mumps and rubella (MMR)
- Bacillus Calmette-Guerin (BCG)
Vaccines that may be recommended if the risk of infection is high:
(This generally means that there is only limited data on the risks of the vaccination, although there are no reports of the vaccine causing harm to the baby.)
- Japanese encephalitis
- Yellow Fever
**According to the CDC, breastfeeding does not adversely affect immunization and is not a contraindication for any vaccine.
For further information, please visit the CDC's website.
Call your doctor if:
- This is your first baby and your contractions are coming in a regular pattern about five minutes apart for one hour and getting progressively harder and lasting longer.
- This is your second baby (or more!) and your contractions are coming in a regular pattern about eight minutes apart for 45 minutes and getting progressively harder and lasting longer.
- Your "water" breaks. This could be a sudden gush of clear liquid or a steady, slow leaking.
- You have bleeding heavy enough to require protection. (A slight bloody mucus discharge may occur from pressure on the cervix and does not necessarily mean labor is impending.)
If any of the above occurs, call your doctor or their answering service. They will call you back and let us know you are on the way.
You will be admitted first to the triage area in labor and delivery to be evaluated. Your nurse will take your temperature, pulse and blood pressure. She or he will ask you questions about your contractions and will usually perform a vaginal examination to check if your cervix has begun to dilate.
The nurse also will use the fetal monitor to assess the frequency of your contractions, your baby's heart rate and how your baby is reacting to your contractions.
When you are in active labor, you will be admitted to a labor, delivery, recovery room (LDR). Each of our LDR rooms is comfortable and spacious, private and has its own bathroom.
Each room has a tub or shower to use during labor. The tub and shower help to alleviate pain and aid in relaxation during and between contractions. Think about how great a bubble bath at home feels when you have had a stressful day. The same effect is true with a bath or shower during labor.
The nursing and medical staff will want to know about your birth plan for you and your baby. This is the best time to discuss your plans for walking, pain relief, if you plan to breastfeed your baby, the name of your pediatrician and your plans for circumcision. The nurse also will need to know if you are allergic to anything, especially medications.
A fetal monitor is often used to obtain information about your baby. It may be indirect, direct or a combination of the two. Fetal monitoring may be intermittent or continuous. If your labor is progressing without complications and your baby is tolerating labor without problems, your nurse may agree to intermittent monitoring with your doctor's permission. This will allow you more freedom to move.
Indirect monitoring also can be done by telemetry (remotely), which allows you to walk throughout labor and your baby will still be monitored. We also can listen to your baby's heartbeat by using a fetoscope.
A sitting or squatting position aids in pushing the baby down through the birth canal. The labor bed will be adjusted to the birthing position when you are close to delivering. When you are ready to have your baby, the necessary equipment is already in your LDR suite. If you require a cesarean delivery, you will be transported to an adjacent surgical suite.
The precise moment of your baby's delivery will be noted. It's a time and date you will always remember. Immediately after being dried and initially checked, your baby can be placed skin to skin on your abdomen or chest. This is a time when baby is usually intensely alert and ready to get acquainted with you. Your baby recognizes your voice, is comforted by hearing your heartbeat when on your chest and may even be eager to try breastfeeding. This is the ideal time to begin, because babies usually are ready to suck and nuzzle the breast. Or, your baby may be placed in a temperature-controlled crib until you are ready to hold him or her.
Your baby will be properly identified, weighed, measured and foot-printed. A four-band system of identification is used to provide security and is part of our infant abduction prevention program. You, your support person, and your family will be able to enjoy your little one. Hold your baby, snuggle, cuddle, touch, admire and breastfeed. Your baby will be ready to suck and will be alert for learning.
You will stay in your LDR room until your vital signs are stable, usually one to three hours. You will then be moved together as a family to the mother-baby unit. You and your baby will most likely be cared for together as a couple by the same nurse.
You will enjoy precious moments together as you share the same room. Mother-baby care provides personal care for you both. It also increases the chance of breastfeeding success, adapts flexible feeding and sleeping schedules to your baby's needs and increases family bonding.
Upon transfer from the LDR, the mother-baby nurse will examine you and your baby thoroughly right at your bedside. Mother and baby are usually not separated. In the first few hours after birth, both mother and baby will receive periodic physical assessments. Your baby will be placed in a bassinet under radiant heat until his or her body temperature stabilizes. The warmer can be brought close to your bed so you can see what the nurse is doing to care for your baby and ask any questions you may have. Your baby will have a complete examination, and you will also be able to see the baby's first bath and can even participate.
How Can We Help You Today?
Need help? We will be delighted to assist you today, so please call us at 404-778-7777. We look forward to hearing from you.